Individual
AMANDA WILLGING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, OTC
Contact information
Practice address
19455 DEERFIELD AVE STE 306, LANSDOWNE, VA 20176-8102
(703) 729-5010
(703) 729-5833
Mailing address
120 FADING STAR CT, STEPHENSON, VA 22656-2056
(540) 684-0951
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002299
VA
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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