Individual
AMANDA MICHELLE STAYROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
512 CRESCENT DR, TROY, OH 45373-2718
(937) 335-7161
Mailing address
6416 PHEASANT HILL RD, DAYTON, OH 45424-4175
(937) 470-4091
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
367998
OH
Other
Enumeration date
07/23/2017
Last updated
07/23/2017
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