Provider Demographics
NPI:1396035473
Name:AMONTE, JENNET K (D,C,)
Entity Type:Individual
Prefix:DR
First Name:JENNET
Middle Name:K
Last Name:AMONTE
Suffix:
Gender:F
Credentials:D,C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 WATER OAK LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2736
Mailing Address - Country:US
Mailing Address - Phone:757-515-6374
Mailing Address - Fax:
Practice Address - Street 1:215 67TH ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2061
Practice Address - Country:US
Practice Address - Phone:757-515-6374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556883111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition