Individual
AMANDA MCILVAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17374 W 158TH ST, OLATHE, KS 66062-6355
(913) 217-8785
Mailing address
17374 W 158TH ST, OLATHE, KS 66062-6355
(913) 217-8785
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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