Healthcare Provider Details

I. General information

NPI: 1811249725
Provider Name (Legal Business Name): AMANDA K JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 ADAMS AVE PKWY STE B
OGDEN UT
84405-6748
US

IV. Provider business mailing address

5275 ADAMS AVE PKWY STE B
OGDEN UT
84405-6748
US

V. Phone/Fax

Practice location:
  • Phone: 801-394-4399
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: