Provider Demographics
NPI:1871872242
Name:PAMPHILIS, ANNAMARIE (RDH, ND)
Entity type:Individual
Prefix:DR
First Name:ANNAMARIE
Middle Name:
Last Name:PAMPHILIS
Suffix:
Gender:F
Credentials:RDH, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 SPRUCEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-2716
Mailing Address - Country:US
Mailing Address - Phone:440-539-0392
Mailing Address - Fax:
Practice Address - Street 1:31015 CENTER RIDGE RD.
Practice Address - Street 2:HEALTH AND BALANCE INSTITUTE, LLC
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-539-0392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31009182174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator