Provider Demographics
NPI:1255611224
Name:HAND, AMY FRALEY (MA, SCAT, ATC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:FRALEY
Last Name:HAND
Suffix:
Gender:F
Credentials:MA, SCAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 WHEAT ST
Mailing Address - Street 2:BLATT PHYSICAL EDUCATION CENTER, 213
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201
Mailing Address - Country:US
Mailing Address - Phone:864-590-5257
Mailing Address - Fax:
Practice Address - Street 1:1300 WHEAT ST
Practice Address - Street 2:BLATT PHYSICAL EDUCATION CENTER, 213
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:864-590-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1260OtherSTATE CERTIFIED ATHLETIC TRAINER
NC1638OtherNORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS
2000001001OtherBOARD OF CERTIFICATION, INC.