Individual
AMANDA GARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
400 MEDICAL PLZ STE 200, LAKE ST LOUIS, MO 63367-1417
(636) 625-2662
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017023148
MO
Other
Enumeration date
08/02/2017
Last updated
07/21/2022
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