Individual
AMANDA DEE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1 UNIVERSITY PLZ, MS 7000, CAPE GIRARDEAU, MO 63701-4710
(573) 986-6764
Mailing address
2647 TRAVELERS WAY, JACKSON, MO 63755-2475
(405) 694-3444
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2006004089
MO
Other
Enumeration date
06/21/2006
Last updated
02/14/2017
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