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General NPI Number Information
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NPI Number | 1902600505
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Entity Type | Individual
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Provider Name | AMANDA ROSE BELFIELD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 10747 ECLIPSE AVE
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City | LA PLATA
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State | MO
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Zip | 63549-1805
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Country | US
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Telephone | 660-346-0729
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Fax |
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Provider Business Mailing Address
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Address Line | 10747 ECLIPSE AVE
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City | LA PLATA
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State | MO
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Zip | 63549-1805
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Country | US
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Telephone | 660-346-0729
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | LC014611146
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License Number State | MO
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