Individual
AMANDA NICOLE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
758 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3385
(678) 985-7190
(678) 985-7158
Mailing address
758 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3385
(678) 985-7190
(678) 985-7158
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002182
GA
Other
Enumeration date
05/05/2014
Last updated
05/12/2014
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