Individual
AMANDA REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 9TH ST, SLIDELL, LA 70458-1416
(985) 960-3759
Mailing address
520 NINTH STREET, SLIDELL, LA 70458
(985) 960-3759
Taxonomy
Speciality
Code
Description
License number
State
2865X1600X
Operational (Transportable) Military General Acute Care Hospital
Primary
—
—
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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