Individual
AMANDA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
W10453 BLACKHAWK TRL, FOX LAKE, WI 53933-9782
(920) 318-0071
Mailing address
W10453 BLACKHAWK TRL, FOX LAKE, WI 53933-9782
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
227800000X
Certified Respiratory Therapist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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