Individual
AMANDA SYTSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 E DUPONT RD STE 1, FORT WAYNE, IN 46825-1545
(260) 266-6060
(260) 425-6395
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37002790A
IN
Other
Enumeration date
10/16/2017
Last updated
12/20/2022
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