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Individual

AMANDA NIEDERHAUSER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1970 DOMINION WAY, COLORADO SPRINGS, CO 80918-1465
(719) 200-6832
Mailing address
9070 CHARITY DR, COLORADO SPRINGS, CO 80920-7368
(719) 200-6832

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT.0014165
CO

Other

Enumeration date
11/23/2013
Last updated
11/23/2013
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