Amanda Jackson, ATC
Specialist/Technologist, Athletic Trainer in Marietta, GA. Individual provider (NPI-1).
NPI number1770017949
StatusActive
Last updated in NPPESApr 14, 2017
Details
- NPI
- 1770017949
- Entity type
- Individual (NPI-1)
- Name
- Amanda Jackson
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 14, 2017
- Last updated
- Apr 14, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT003082 | GA | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | LAT-2819 | NC |
Practice location
1269 Barclay Cir SeMarietta, GA 30060-2903
Phone 919-370-0423
Mailing address
102 Wethersfield DrCary, NC 27513-4965
Phone 919-370-0423
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All 39 Athletic Trainer providers in Marietta · All 9,180 providers in Marietta
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