Individual
AMANDA DONELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
7166 CONSTITUTION DR APT A, INDIANAPOLIS, IN 46256-2409
(765) 432-8857
Mailing address
7166 CONSTITUTION DR APT A, INDIANAPOLIS, IN 46256-2409
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002083A
IN
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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