Provider Demographics
NPI:1942627930
Name:HARVEY, AMANDA NIKOLICH (DC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:NIKOLICH
Last Name:HARVEY
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 1:650 CHERRINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4300
Mailing Address - Country:US
Mailing Address - Phone:412-877-2286
Mailing Address - Fax:
Practice Address - Street 1:291 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-3401
Practice Address - Country:US
Practice Address - Phone:724-625-3466
Practice Address - Fax:724-772-5564
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor