Individual
AMANDA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1250 SOUTH CEDAR CREST BLVD, SUITE 110, ALLENTOWN, PA 18103-6224
(610) 435-1003
(610) 435-3184
Mailing address
PO BOX 1754, ALLENTOWN, PA 18105-1754
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA054519
PA
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
09/10/2010
Last updated
10/29/2014
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