Provider Demographics
NPI:1477872224
Name:D'AMATO, ANDRIA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDRIA
Middle Name:MARIE
Last Name:D'AMATO
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 1:841 SOUTHWESTERN RUN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3671
Mailing Address - Country:US
Mailing Address - Phone:330-629-9292
Mailing Address - Fax:330-629-9339
Practice Address - Street 1:841 SOUTHWESTERN RUN
Practice Address - Street 2:SUITE 2
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3671
Practice Address - Country:US
Practice Address - Phone:330-629-9292
Practice Address - Fax:330-629-9339
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor