Provider Demographics
NPI:1255759205
Name:AMDAHL, BRITTNEY JOY (DACM, DIPL AC, LAC)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:JOY
Last Name:AMDAHL
Suffix:
Gender:F
Credentials:DACM, DIPL AC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EAST AVE.
Mailing Address - Street 2:SUITE D
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066
Mailing Address - Country:US
Mailing Address - Phone:619-955-0788
Mailing Address - Fax:
Practice Address - Street 1:201 EAST AVE.
Practice Address - Street 2:SUITE D
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066
Practice Address - Country:US
Practice Address - Phone:619-955-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1848171100000X
CAAC15278171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist