Provider Demographics
NPI:1083152078
Name:DEMUTH, UVINI AMANTHI (DC)
Entity Type:Individual
Prefix:DR
First Name:UVINI
Middle Name:AMANTHI
Last Name:DEMUTH
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 1:71 COUNTY ROAD 120 STE 300
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4924
Mailing Address - Country:US
Mailing Address - Phone:515-441-4876
Mailing Address - Fax:
Practice Address - Street 1:71 COUNTY ROAD 120 STE 300
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56303-4924
Practice Address - Country:US
Practice Address - Phone:515-441-4876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor