Provider Demographics
NPI:1770636524
Name:REICH, AMY LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LEIGH
Last Name:REICH
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 1:3450 ACWORTH DUE WEST RD.
Mailing Address - Street 2:SUITE 330
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-1002
Mailing Address - Country:US
Mailing Address - Phone:678-744-7222
Mailing Address - Fax:678-574-5223
Practice Address - Street 1:3450 ACWORTH DUE WEST RD.
Practice Address - Street 2:SUITE 330
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1002
Practice Address - Country:US
Practice Address - Phone:678-744-7222
Practice Address - Fax:678-574-5223
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV12302Medicare UPIN
GA35ZCJWTMedicare PIN