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1780164590
AMANDA LARISCEY
VIDALIA, GA
NPI
1780164590
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2018-08-21
Last Update Date
2022-01-07
Business Address
AMANDA LARISCEY PA-C
122 ALICE COLEMAN DRIVE
VIDALIA, GA 30474
Phone number: 912-805-2273
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Mailing Address
AMANDA LARISCEY PA-C
PO BOX 2324
VIDALIA, GA 30475-2324
Phone number:
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