Provider Demographics
NPI:1629251681
Name:AMANTEA, LOUIS (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:AMANTEA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-2125
Mailing Address - Country:US
Mailing Address - Phone:508-234-8222
Mailing Address - Fax:508-234-7558
Practice Address - Street 1:800 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-2125
Practice Address - Country:US
Practice Address - Phone:508-234-8222
Practice Address - Fax:508-234-7558
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35001OtherBLUE CROSS OF MA
MA35461OtherHARVARD PILGRIM HEALTH
MA722474OtherTUFTS HEALTHCARE
MAY35001Medicare PIN
MAY35001OtherBLUE CROSS OF MA