Individual
AMANDA ROSELLE GROAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1816 DURANGO CT, TULARE, CA 93274-8566
(559) 368-8926
Mailing address
1816 DURANGO CT, TULARE, CA 93274-8566
(559) 368-8926
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
210077
CA
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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