Individual
AMANDA MARVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
11240 WAPLES MILL RD, SUITE 403, FAIRFAX, VA 22030-6078
(703) 810-5286
Mailing address
11240 WAPLES MILL RD, SUITE 403, FAIRFAX, VA 22030-6078
(703) 810-5286
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000658
VA
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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