Provider Demographics
NPI:1043466451
Name:FRIEDHOFF, AMANDA SIMONE (DC)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:SIMONE
Last Name:FRIEDHOFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 ROSWELL RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062
Mailing Address - Country:US
Mailing Address - Phone:770-509-9717
Mailing Address - Fax:770-509-8796
Practice Address - Street 1:3901 ROSWELL RD
Practice Address - Street 2:SUITE 208
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:770-509-9717
Practice Address - Fax:770-509-8796
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor