Provider Demographics
NPI:1144355165
Name:SIMONDS, AMANDA RENEE (DC)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:RENEE
Last Name:SIMONDS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:RENEE
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:523 REGINA CT
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8193
Mailing Address - Country:US
Mailing Address - Phone:314-974-5934
Mailing Address - Fax:
Practice Address - Street 1:1008 SW BLUE PKWY
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2100
Practice Address - Country:US
Practice Address - Phone:816-347-1515
Practice Address - Fax:816-347-0398
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007004600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor