Provider Demographics
NPI:1376132654
Name:MONTAGNA, AMANDA (DC)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:MONTAGNA
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 1:419 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-1925
Mailing Address - Country:US
Mailing Address - Phone:315-866-1113
Mailing Address - Fax:315-574-1698
Practice Address - Street 1:419 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1925
Practice Address - Country:US
Practice Address - Phone:315-866-1113
Practice Address - Fax:315-574-1698
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013414111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor