Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 34.012861 | OH |
NPI | 1023452257 |
---|---|
Provider Name | Dr. Amanda Rose Mook |
First Address | Chesterland, OH 44026-2447 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2013 |
Last Update Date | 06/12/2018 |