Provider Demographics
NPI:1497911663
Name:ESTEP, AMANDA JADE (MS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JADE
Last Name:ESTEP
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13035 ATKINS CIRCLE DR
Mailing Address - Street 2:APT. #107
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3771
Mailing Address - Country:US
Mailing Address - Phone:937-725-6523
Mailing Address - Fax:
Practice Address - Street 1:7301 SARDIS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-6063
Practice Address - Country:US
Practice Address - Phone:704-366-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer