Individual
AMANDA L MCKIBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1873
(937) 641-3291
(937) 641-4619
Mailing address
1 CHILDRENS PLZ, DAYTON, OH 45404-1873
(937) 641-3291
(937) 641-4619
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT004579
OH
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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