Individual
AMANDA HERBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
393 MAIN ST, TONAWANDA, NY 14150-3815
(716) 715-4101
Mailing address
393 MAIN ST, TONAWANDA, NY 14150-3815
(716) 715-4101
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300449-1
NY
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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