Provider Demographics
NPI:1457358210
Name:DUNCAN, AMANDA ELIZABETH X (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:DUNCAN
Suffix:X
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 1:129 PORTERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-2444
Mailing Address - Country:US
Mailing Address - Phone:724-758-4099
Mailing Address - Fax:724-758-7316
Practice Address - Street 1:129 PORTERSVILLE RD
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-2444
Practice Address - Country:US
Practice Address - Phone:724-758-4099
Practice Address - Fax:724-758-7316
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007368L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017706800004Medicaid
PA028915Medicare ID - Type Unspecified
PA0017706800004Medicaid