Provider Demographics
NPI:1720659618
Name:BELMUDES, AMANDA N (MS, ATC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:BELMUDES
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 1:13171 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:OAK HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92344-4112
Mailing Address - Country:US
Mailing Address - Phone:760-998-7712
Mailing Address - Fax:
Practice Address - Street 1:181 SPRING ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30639
Practice Address - Country:US
Practice Address - Phone:800-860-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
GA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer