Provider Demographics
NPI:1447557889
Name:SKEEN, AMANDA (DC)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:SKEEN
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 1:280 E CORPORATE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-2951
Mailing Address - Country:US
Mailing Address - Phone:208-287-2032
Mailing Address - Fax:208-287-2033
Practice Address - Street 1:280 E CORPORATE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2951
Practice Address - Country:US
Practice Address - Phone:208-287-2032
Practice Address - Fax:208-287-2033
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor