Most Relevant Information
Provider Data
| NPI Number: | 1003408139 |
| Provider Name: | AMANDA MACE |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/10/2021 |
| Last Updated: | 02/10/2021 |
Provider Practice Location
45840 STATE ROUTE 7
NEW MATAMORAS
OH
457676148
Practice Location Phone/Fax
| Phone: | 7405251412 |
| Fax: |
Provider Mailing Location
45840 STATE ROUTE 7
NEW MATAMORAS
OH
457676148
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |