Individual
ALICIA MARIE AMADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1 JOHN MARSHALL DR, HUNTINGTON, WV 25755-0002
(805) 202-9256
Mailing address
1 JOHN MARSHALL DR, HUNTINGTON, WV 25755-8200
(805) 202-9256
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, DEVELOPMENTAL, REHABILITATIVE AND RESTORATIVE SERVICE PROCEDURES
CA
Enumeration date
05/22/2019
Last updated
03/03/2022
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