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Individual

AMANDA LOUDERBACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4212 SOUTHTOWNE DR, EAU CLAIRE, WI 54701
(715) 832-1400
Mailing address
2304 SUNSET DR. #6, EAU CLAIRE, WI 54703

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
988-039
WI

Other

Enumeration date
11/04/2010
Last updated
11/04/2010
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