Provider Demographics
NPI:1174568943
Name:RICE, AMANDA RUTH (ATC)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:RUTH
Last Name:RICE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 1/2 GOLDENROD AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2145
Mailing Address - Country:US
Mailing Address - Phone:714-745-2927
Mailing Address - Fax:
Practice Address - Street 1:612 1/2 GOLDENROD AVE
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2145
Practice Address - Country:US
Practice Address - Phone:714-745-2927
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer