Provider Demographics
NPI:1609052570
Name:ANDERSON, AMY ALLISON (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ALLISON
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ALLISON
Other - Last Name:PANYKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1421 E NINE MILE RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5723
Mailing Address - Country:US
Mailing Address - Phone:850-484-7735
Mailing Address - Fax:850-484-7736
Practice Address - Street 1:1421 E NINE MILE RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5723
Practice Address - Country:US
Practice Address - Phone:850-484-7735
Practice Address - Fax:850-484-7736
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9490111N00000X
TN2596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64063OtherBLUE CROSS BLUE SHEILD