Individual
AMANDA K LAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-6688
Mailing address
11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE 'C', LOMA LINDA, CA 92354-2804
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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