Provider Demographics
NPI:1376616748
Name:BESS-FISHEL, AMANDA YVETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:YVETTE
Last Name:BESS-FISHEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:YVETTE
Other - Last Name:BESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:813 E ROOSEVELT BLVD STE K
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5169
Mailing Address - Country:US
Mailing Address - Phone:704-225-1918
Mailing Address - Fax:704-225-9719
Practice Address - Street 1:813 E ROOSEVELT BLVD STE K
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5169
Practice Address - Country:US
Practice Address - Phone:704-225-1918
Practice Address - Fax:704-225-9719
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890826VMedicaid
NCU73948Medicare UPIN
NC890826VMedicaid