Provider Demographics
NPI:1831492297
Name:AMATO, MICAH AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:MICAH
Middle Name:AARON
Last Name:AMATO
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 1:107 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2078
Mailing Address - Country:US
Mailing Address - Phone:781-438-5755
Mailing Address - Fax:781-438-7635
Practice Address - Street 1:107 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2078
Practice Address - Country:US
Practice Address - Phone:781-438-5755
Practice Address - Fax:781-438-7635
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor