Individual
AMANDA DECLERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3401 N CENTER ST STE 100, LEHI, UT 84043-7498
(801) 753-7770
(801) 753-7775
Mailing address
136 W 400 N APT 29, PROVO, UT 84601-2887
(515) 238-5551
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
13525788-4810
UT
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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