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Individual

MRS. AMANDA KRISTINE ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1493 HIGHWAY 92, ACWORTH, GA 30102
(716) 515-8296
Mailing address
244 DERBY CT, ACWORTH, GA 30102-1438

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002410
GA

Other

Enumeration date
10/09/2018
Last updated
10/09/2018
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