MEDICARE: AMANDA DANA OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT002924	GA
2	152W00000X	Optometrist	2088	AZ
3	152W00000X	Optometrist	7951T	TX

General Provider Information

NPI Number	:	1841526126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DANA OD

Provider Business Mailing Address
First Line	:	8478 E CASS AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85708-1279
Country	:	US
Telephone Number	:	541-941-6966
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 S PACIFIC AVE STE D
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85365-3547
Country	:	US
Telephone Number	:	928-782-7557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2009
Last Update Date	:	09/23/2022

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