Provider Demographics
NPI:1730601998
Name:FORREST-READDY, AMY ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:FORREST-READDY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:FORREST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:528 TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-3036
Mailing Address - Country:US
Mailing Address - Phone:562-270-5503
Mailing Address - Fax:
Practice Address - Street 1:4425 ATLANTIC AVE STE A10
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2245
Practice Address - Country:US
Practice Address - Phone:562-270-5503
Practice Address - Fax:562-961-7660
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor