Provider Demographics
NPI:1851639959
Name:LUNDY, AMANDA KAYE (LMT)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:KAYE
Last Name:LUNDY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6324 LITTLE HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:PHILPOT
Mailing Address - State:KY
Mailing Address - Zip Code:42366-9768
Mailing Address - Country:US
Mailing Address - Phone:270-302-7637
Mailing Address - Fax:
Practice Address - Street 1:1020 HALIFAX DR # 1008
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6991
Practice Address - Country:US
Practice Address - Phone:270-683-4772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-4115175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath