Individual
AMANDA MICHELLE WASSENAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLS
Contact information
Practice address
3200 CANYON LAKE DR STE 1, RAPID CITY, SD 57702-8114
(605) 355-2227
Mailing address
5260 BASSWOOD ST, RAPID CITY, SD 57703-6500
(605) 390-6465
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
—
—
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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