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1114300332
AMANDA RYAN
GREEN BAY, WI
NPI
1114300332
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QV0200X Clinic/Center, VA
(Licence: NY 060491)
Enumeration Date
2015-07-07
Last Update Date
2015-07-07
Business Address
-- AMANDA RYAN
2851 UNIVERSITY AVE
GREEN BAY, WI 54311-5855
Phone number: 716-440-4117
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Mailing Address
-- AMANDA RYAN
97 PROMENADE LN
WILLIAMSVILLE, NY 14221-1924
Phone number: 716-440-4117
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