Provider Demographics
NPI:1578875951
Name:WESTBROOK, AMANDA ROSE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ROSE
Last Name:WESTBROOK
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:PO BOX 5122
Mailing Address - Street 2:
Mailing Address - City:SALT SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32134-5122
Mailing Address - Country:US
Mailing Address - Phone:352-685-6202
Mailing Address - Fax:
Practice Address - Street 1:14100 N HIGHWAY 19 STE B
Practice Address - Street 2:
Practice Address - City:SALT SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32134-8632
Practice Address - Country:US
Practice Address - Phone:352-685-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor