Provider Demographics
NPI:1801982079
Name:HESS, AMANDA LUANN (DC)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LUANN
Last Name:HESS
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 1:5532 N HENRY BLVD
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3220
Mailing Address - Country:US
Mailing Address - Phone:770-389-4744
Mailing Address - Fax:770-389-4760
Practice Address - Street 1:5532 N HENRY BLVD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3220
Practice Address - Country:US
Practice Address - Phone:770-389-4744
Practice Address - Fax:770-389-4760
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU98216Medicare UPIN