Individual
AMANDA CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1701 FRANKFORT RD, SHELBYVILLE, KY 40065-9451
(502) 633-2344
Mailing address
1701 FRANKFORT RD, SHELBYVILLE, KY 40065-9451
(502) 633-2344
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
080702119
KY
225700000X
Massage Therapist
164841
KY
Other
Enumeration date
05/05/2019
Last updated
05/05/2019
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