Most Relevant Information
Provider Data
| NPI Number: | 1003364894 |
| Provider Name: | AMANDA FARLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/21/2016 |
| Last Updated: | 09/21/2016 |
Provider Practice Location
612 KIMBERLY
APT 201
LAKE ORION
MI
483622950
Practice Location Phone/Fax
| Phone: | 2693696066 |
| Fax: |
Provider Mailing Location
612 KIMBERLY
APT 201
LAKE ORION
MI
483622950
Provider Mailing Phone/Fax
| Phone: | 2693696066 |
| Fax: |