Individual
AMANDA G MANCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2002 SAN BERNARDO AVE, LAREDO, TX 78040-3142
(956) 334-3938
Mailing address
411 ALBANY DR, LAREDO, TX 78045-7806
(956) 635-0638
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
—
Enumeration date
07/31/2017
Last updated
07/31/2017
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