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Individual

AMIYA SUMMER WILT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
401 N FAIRVIEW ST, LOCK HAVEN, PA 17745-2390
(814) 312-2693
Mailing address
401 N FAIRVIEW ST, LOCK HAVEN, PA 17745-2342

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
07/21/2025
Last updated
07/21/2025
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