Provider Demographics
NPI:1942559158
Name:BURTON, AMANDA L
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:L
Last Name:BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7271 PRATTS FALLS RD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9645
Mailing Address - Country:US
Mailing Address - Phone:315-882-0804
Mailing Address - Fax:
Practice Address - Street 1:7271 PRATTS FALLS RD
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-9645
Practice Address - Country:US
Practice Address - Phone:315-882-0804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist