Provider Demographics
NPI:1558801985
Name:MAGIER, AMANDA BETH (ATC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:BETH
Last Name:MAGIER
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 1:35 BRANDEIS RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2707
Mailing Address - Country:US
Mailing Address - Phone:617-780-1228
Mailing Address - Fax:
Practice Address - Street 1:35 BRANDEIS RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2707
Practice Address - Country:US
Practice Address - Phone:617-780-1228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-05
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer