Individual
AMANDA NICOLE POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
211 SCOFIELD ROAD, LAKE LUZERNE, NY 12846
(516) 871-7124
Mailing address
PO BOX 662, LAKE LUZERNE, NY 12846-0662
(516) 871-7124
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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