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1740581909
AMANDA LOUDERBACK
EAU CLAIRE, WI
NPI
1740581909
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: WI 988-039)
Enumeration Date
2010-11-04
Last Update Date
2010-11-04
Business Address
AMANDA LOUDERBACK
4212 SOUTHTOWNE DR
EAU CLAIRE, WI 54701
Phone number: 715-832-1400
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Mailing Address
AMANDA LOUDERBACK
2304 SUNSET DR. #6
EAU CLAIRE, WI 54703
Phone number:
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