| NPI | 1841785516 |
|---|---|
| Former Name | AMANDA LEIGH CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36000919A) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |