Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 12457 | FL |
NPI | 1528563525 |
---|---|
Provider Name | Dr. Amanda Ashley Metzger |
First Address | Tampa, FL 33626-1608 |
Second Address | Tampa, FL 33626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2018 |
Last Update Date | 27/06/2018 |