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NPI Code Detail

MEDICARE: MISS AMANDA RENE' FRANK A.T.C.

MEDICARE: MISS AMANDA RENE' FRANK A.T.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerCA

General Provider Information

NPI Number : 1952503351
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS AMANDA RENE' FRANK A.T.C.
Provider Business Mailing Address
First Line : 16114 CHALLIS ST
Second Line :
City : FOUNTAIN VALLEY
State : CA
Zip : 92708-1431
Country : US
Telephone Number : 562-477-2322
Fax Number :
Provider Business Practice Location Address
First Line : 5772 BOLSA AVE
Second Line : SUITE 101
City : HUNTINGTON BEACH
State : CA
Zip : 92649-1134
Country : US
Telephone Number : 714-897-3589
Fax Number : 714-897-1316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2007
Last Update Date : 07/08/2007

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Directions to “ MISS AMANDA RENE' FRANK A.T.C.” Practice Location

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