Provider Demographics
NPI:1639300759
Name:JOHNSON, AMANDA CHRISTIANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:CHRISTIANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:CHRISTIANNE
Other - Last Name:HOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:146 E DUNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-2330
Mailing Address - Country:US
Mailing Address - Phone:603-318-0936
Mailing Address - Fax:
Practice Address - Street 1:146 E DUNSTABLE RD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-2330
Practice Address - Country:US
Practice Address - Phone:603-318-0936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH839-0409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor