Individual
AMANDA KAY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3015 N SCOTTSDALE RD UNIT 4235, SCOTTSDALE, AZ 85251-7263
(480) 249-8116
Mailing address
3015 N SCOTTSDALE RD UNIT 4235, SCOTTSDALE, AZ 85251-7263
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
297127
AZ
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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