Individual
MRS. AMANDA LYNN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4000 W LAKE AVE, GLENVIEW, IL 60026-1239
(847) 486-4627
Mailing address
319 W RIVERSIDE DR, LAKEMOOR, IL 60051-8774
(847) 486-4627
(847) 486-5702
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.001971
IL
Other
Enumeration date
08/08/2006
Last updated
12/07/2011
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