National Provider Identifier

Amanda Shaw, ATC

Amanda Shaw, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Avon, NY and a listed phone number of (716) 560-0169.

NPI 1538732755Avon, NYAthletic Trainer

Profile Overview

NPI
1538732755
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
July 24, 2021
Last Updated
July 24, 2021

Practice Location

  • 5568 East Avon Road
  • Avon, NY 14414

Phone: (716) 560-0169

Mailing Address

  • 1791 Route 238
  • Warsaw, NY 14569-9587

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1538732755
Entity Type
Individual
Last Name
Shaw
First Name
Amanda
Credential
ATC
Mailing Street Address
1791 Route 238
Mailing City
Warsaw
Mailing State
NY
Mailing ZIP Code
14569-9587
Mailing Country
US
Practice Street Address
5568 East Avon Road
Practice City
Avon
Practice State
NY
Practice ZIP Code
14414
Practice Country
US
Practice Phone
(716) 560-0169
Enumeration Date
July 24, 2021
Last Updated
July 24, 2021
Sex
Female
Sole Proprietor
No
Certification Date
July 15, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)