Most Relevant Information
Provider Data
NPI Number: | 1003417379 |
Provider Name: | AMANDA R DEOWDAT |
Entity Type: | Individual |
Taxonomy Code: | 225700000X |
Specialty: | Massage Therapist |
License Number: |
Most Important Dates
Enumeration Date: | 11/04/2020 |
Last Updated: | 11/04/2020 |
Provider Practice Location
7515 LYNDALE AVE S
RICHFIELD
MN
554234091
Practice Location Phone/Fax
Phone: | 6512691899 |
Fax: |
Provider Mailing Location
7515 LYNDALE AVE S
RICHFIELD
MN
554234091
Provider Mailing Phone/Fax
Phone: | 6512691899 |
Fax: |