Provider Demographics
NPI:1275712184
Name:HOUSH, AMANDA MICHELLE (DC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MICHELLE
Last Name:HOUSH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2800 SIENA CIR # A
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3564
Mailing Address - Country:US
Mailing Address - Phone:405-206-9312
Mailing Address - Fax:405-577-6371
Practice Address - Street 1:1809 COMMONS CIR
Practice Address - Street 2:A
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099
Practice Address - Country:US
Practice Address - Phone:405-577-6268
Practice Address - Fax:405-577-6371
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor