Healthcare Provider Details

I. General information

NPI: 1821174244
Provider Name (Legal Business Name): AMY MICHELLE ENGEL ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 MARSH RD
WILMINGTON DE
19810-4581
US

IV. Provider business mailing address

4 RIDGEWAY SQ APT C
WILMINGTON DE
19810-1924
US

V. Phone/Fax

Practice location:
  • Phone: 302-475-7500
  • Fax:
Mailing address:
  • Phone: 302-562-4031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: