Individual
AMANDA ANNE BOIVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4696 PAULETTE PL, SANTA ROSA, CA 95403-7553
(707) 481-0978
Mailing address
4696 PAULETTE PL, SANTA ROSA, CA 95403-7553
(707) 481-0978
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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