Individual
MRS. AMANDA MARIE MANGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
217 EVERINGHAM RD, SYRACUSE, NY 13205-3236
(315) 481-3120
Mailing address
217 EVERINGHAM RD, SYRACUSE, NY 13205-3236
(315) 481-3120
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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