Individual
MRS. AMANDA LEE FADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 452-3133
Mailing address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 916-9309
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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