Individual
AMANDA DEKANICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2043 PLEASANT VIEW DR, NEW BRIGHTON, MN 55112-5352
(651) 707-7026
Mailing address
2043 PLEASANT VIEW DR, NEW BRIGHTON, MN 55112-5352
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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