Basic Information
| Provider Information | |||||||||
| NPI: | 1982008413 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLYNTJES | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | MS, ATC, CES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 CHARITY CIR | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553634700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3207608454 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3366 OAKDALE AVE N | ||||||||
| Address2: | |||||||||
| City: | ROBBINSDALE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554222948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635207870 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2014 | ||||||||
| LastUpdateDate: | 10/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 2266 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.