Individual
AMANDA KAY RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1612 GINGERCREEK CT, SYCAMORE, IL 60178-2722
(815) 823-3909
Mailing address
1612 GINGERCREEK CT, SYCAMORE, IL 60178-2722
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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