Individual
MRS. AMANDA CAROL WOLF
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3950 NEWMAN RD, JOPLIN, MO 64801-1512
(417) 625-3174
(417) 625-3134
Mailing address
1118 N PENNSYLVANIA ST, WEBB CITY, MO 64870-1150
(417) 673-5123
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2004010790
MO
2255A2300X
Athletic Trainer
24-00313
KS
Other
Enumeration date
05/04/2006
Last updated
07/08/2007
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