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General NPI Number Information
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NPI Number | 1942788369
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Entity Type | Individual
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Provider Name | BRITTANY ALYSE BAMANN ATC
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Gender | Female
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 4901 LAC DE VILLE BLVD SUITE 110
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City | ROCHESTER
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State | NY
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Zip | 14618-5648
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Country | US
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Telephone | 585-397-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 62 COVINGTON RD
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City | ROCHESTER
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State | NY
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Zip | 14617-4528
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Country | US
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Telephone | 585-397-5000
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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 | 003630-1
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License Number State | NY
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