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Individual

AMANDA SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
5568 EAST AVON ROAD, AVON, NY 14414
(716) 560-0169
Mailing address
1791 ROUTE 238, WARSAW, NY 14569-9587

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
NY

Other

Enumeration date
07/24/2021
Last updated
07/24/2021
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