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Individual

MRS. AMANDA JANE CUMMINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
109 PLAZA DR, SAINT CLAIRSVILLE, OH 43950-7713
(740) 695-2090
(740) 695-4116
Mailing address
109 PLAZA DR, SAINT CLAIRSVILLE, OH 43950-7713
(740) 695-2090
(740) 695-4116

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005861RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01358
STATE LICENSE
WV
05
352672
OH
Enumeration date
05/09/2011
Last updated
04/02/2020
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