West Forsyth Pain Management

NPI 1053692079 - Physician Assistant - 363AM0700X

NPI Details
NPI 1053692079
Enumeration Date 09/03/2011
Last Updated 09/03/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name AMANDA ANNE AMANDA
Position PHYSICIAN ASSISTANT
Phone (336) 740-9444
Fax (336) 740-9445
Practice Location
2554 LEWISVILLE CLEMMONS RD
SUITE 211
CLEMMONS NC, 27012-8110, US
Phone (336) 740-9444
Fax (336) 740-9445
Business Location
2554 LEWISVILLE CLEMMONS RD
SUITE 211
CLEMMONS NC, 27012-8110, US
Phone (336) 740-9444
Fax (336) 740-9445
Toxanomy
Taxonomy Code 363AM0700X
License State North Carolina
License Number 101887
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According to our database, West Forsyth Pain Management NPI is 1053692079, taxonomy code is 363AM0700X and license number is 101887, license state is located at North Carolina. West Forsyth Pain Management physically located at 2554 Lewisville Clemmons Rd, Clemmons NC, 27012-8110. NPI Number 1033115704 has the healthcare provider type.

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1053692079 NPI number is provided on an as is basis without warranty of any kind. 1053692079 is maintained by the National Plan & Provider Enumeration System. The contents of West Forsyth Pain Management are for informational purposes only.