Provider Demographics
NPI:1578693313
Name:ROSSI, AMANDA BARRETT (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:BARRETT
Last Name:ROSSI
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 1:1915 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3056
Mailing Address - Country:US
Mailing Address - Phone:248-203-9988
Mailing Address - Fax:248-203-9983
Practice Address - Street 1:1915 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3056
Practice Address - Country:US
Practice Address - Phone:248-203-9988
Practice Address - Fax:248-203-9983
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor