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Individual

AMANDA LEIGH RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, ATC, LAT

Contact information

Practice address
501 N MAIN ST, LOUISBURG, NC 27549-2335
(919) 497-3435
(919) 496-7330
Mailing address
1404 RIPLEY WOODS ST, WAKE FOREST, NC 27587-5277
(423) 364-4684
(919) 496-7330

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1410
NC

Other

Enumeration date
07/08/2009
Last updated
07/08/2009
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