Individual
MARK AMENDOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
646 HOLLEY RD, SWEET HOME, OR 97386-3344
(541) 451-6272
Mailing address
646 HOLLEY RD, SWEET HOME, OR 97386-3344
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5201
OR
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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