Provider Demographics
NPI:1710159660
Name:CUSHMAN, AMANDA MARY (DC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARY
Last Name:CUSHMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARY
Other - Last Name:BATTERBEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1424 N M 52
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1235
Mailing Address - Country:US
Mailing Address - Phone:989-720-2225
Mailing Address - Fax:
Practice Address - Street 1:1424 N M 52
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1235
Practice Address - Country:US
Practice Address - Phone:989-720-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor