Amy Johanna Vannederpelt, ATC, LAT
Specialist/Technologist, Athletic Trainer in Lowell, MA. Individual provider (NPI-1).
NPI number1356486849
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1356486849
- Entity type
- Individual (NPI-1)
- Name
- Ms. Amy Johanna Vannederpelt
- Credential
- ATC, LAT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 010702055 | MA | Yes |
Practice location
1 University AveLowell, MA 01854-2827
Phone 978-934-2310
Mailing address
218 School StWaltham, MA 02451-4551
Phone 781-492-7669
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