Provider Demographics
NPI:1184803744
Name:FELTON, AMANDA M (ATC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:FELTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11301 COMMERCE DR
Mailing Address - Street 2:STE B
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-8200
Mailing Address - Country:US
Mailing Address - Phone:616-895-4770
Mailing Address - Fax:616-895-4774
Practice Address - Street 1:11301 COMMERCE DR
Practice Address - Street 2:STE B
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-8200
Practice Address - Country:US
Practice Address - Phone:616-895-4770
Practice Address - Fax:616-895-4774
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer