Provider Demographics
NPI:1902144900
Name:BACHHUBER, AMY (LAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BACHHUBER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N. ELEVATION ST. SUITE 3
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1167
Mailing Address - Country:US
Mailing Address - Phone:906-231-3109
Mailing Address - Fax:844-965-9113
Practice Address - Street 1:1101 NORTH ELEVATION STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1167
Practice Address - Country:US
Practice Address - Phone:906-231-3109
Practice Address - Fax:844-965-9113
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5402000029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist