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General NPI Number Information
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NPI Number | 1205497252
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Entity Type | Individual
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Provider Name | AMANDA INSUA SIMON ATC
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 8405 N PIMA CENTER PKWY STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4669
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Country | US
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Telephone | 602-648-5444
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Fax | 602-772-3801
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Provider Business Mailing Address
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Address Line | PO BOX 80217
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City | PHOENIX
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State | AZ
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Zip | 85060-0217
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Country | US
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Telephone | 602-385-2115
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Fax | 480-418-3323
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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