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General NPI Number Information
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NPI Number | 1699161869
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Entity Type | Individual
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Provider Name | AMANDA LEE BACHMANN ATC
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Gender | Female
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 342 FIFTH AVE
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City | PELHAM
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State | NY
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Zip | 10803-1204
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Country | US
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Telephone | 914-738-1748
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Fax |
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Provider Business Mailing Address
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Address Line | 112 ARROWOOD DR
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City | MILFORD
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State | PA
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Zip | 18337-7449
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Country | US
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Telephone | 570-832-1874
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Fax |
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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 | 0024311
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT005797
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License Number State | PA
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