Provider Demographics
NPI:1912003484
Name:APFELBLAT, AMANDA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LEE
Last Name:APFELBLAT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:COUNTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30900 FORD RD
Mailing Address - Street 2:STE: C
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1892
Mailing Address - Country:US
Mailing Address - Phone:734-838-0353
Mailing Address - Fax:734-838-0359
Practice Address - Street 1:30900 FORD RD
Practice Address - Street 2:STE: C
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1892
Practice Address - Country:US
Practice Address - Phone:734-838-0353
Practice Address - Fax:734-838-0359
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950H226690OtherBC/BS OF MI PIN
MI950H226690OtherBCN PIN