Provider Demographics
NPI:1891897351
Name:AMYOTTE, BEVERLY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:ANN
Last Name:AMYOTTE
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 1:3721 SW PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-2002
Mailing Address - Country:US
Mailing Address - Phone:785-266-9064
Mailing Address - Fax:
Practice Address - Street 1:3721 SW PLAZA DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66609-2002
Practice Address - Country:US
Practice Address - Phone:785-266-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC-03770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS023896Medicare ID - Type Unspecified