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Individual

AMANDA ROSE HUDEPOHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3801 HAUCK RD, CINCINNATI, OH 45241-4607
(513) 563-1505
Mailing address
11129 KENWOOD RD, BLUE ASH, OH 45242-1817

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004217
OH

Other

Enumeration date
03/04/2015
Last updated
02/03/2017
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