Provider Demographics
NPI:1275780348
Name:BYERS, AMANDA RACHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:RACHELLE
Last Name:BYERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:826 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2526
Mailing Address - Country:US
Mailing Address - Phone:850-769-1404
Mailing Address - Fax:850-769-0748
Practice Address - Street 1:826 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2526
Practice Address - Country:US
Practice Address - Phone:850-769-1404
Practice Address - Fax:850-769-0748
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4302152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist