Individual
AMANDA BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 BOB WHITE BLVD, PULASKI, VA 24301-4404
(540) 980-9368
Mailing address
324 AUSTIN LN, WYTHEVILLE, VA 24382-5996
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202210027
VA
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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