Provider Demographics
NPI:1669776985
Name:LENTH, AMANDA MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MICHELLE
Last Name:LENTH
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 1:1806 STERLING PALMS CT APT 302
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-1728
Mailing Address - Country:US
Mailing Address - Phone:813-481-8289
Mailing Address - Fax:813-793-7058
Practice Address - Street 1:1806 STERLING PALMS CT APT 302
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-1728
Practice Address - Country:US
Practice Address - Phone:813-481-8289
Practice Address - Fax:813-793-7058
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor