Individual
AMANDA WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
163 KETAY DR S, EAST NORTHPORT, NY 11731-5032
(347) 628-1305
Mailing address
163 KETAY DR S, EAST NORTHPORT, NY 11731-5032
(347) 628-1305
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/11/2021
Last updated
04/11/2021
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