Individual
AMANDA PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
38882 MENTOR AVE, WILLOUGHBY, OH 44094-7875
(440) 953-9999
Mailing address
38882 MENTOR AVE, WILLOUGHBY, OH 44094-7875
(440) 953-9999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005731RX
OH
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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