Brown, Amanda

Brown, Amanda is an individual health care provider with primary practice located at 20 Brickyard Dr Apt E17, Bloomington IL 61701-7071. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Brown, Amanda can be contacted via phone (937) 405-5116.

Contact Information

Primary practice address
20 Brickyard Dr Apt E17 Bloomington IL 61701-7071
Phone: (937) 405-5116
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 096.003888 Illinois

Profile Details

NPI number 1437553021
LBN Legal business name Brown, Amanda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2014
Last updated Oct 10th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437553021 NPPES
Illinois Other 096.003888 STATE LICENSE

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