Individual
AMANDA RENEE PICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 SPRUCE ST, 3 DULLES BUILDING, PHILADELPHIA, PA 19104-4206
(215) 349-8222
Mailing address
3400 SPRUCE ST, 3 DULLES BUILDING, PHILADELPHIA, PA 19104-4206
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052629
PA
Other
Enumeration date
11/27/2007
Last updated
03/18/2011
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