Healthcare Provider Details

I. General information

NPI: 1821916644
Provider Name (Legal Business Name): AMANDA GILES, DC, CCSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 W NINE MILE RD STE 1
PENSACOLA FL
32534-9469
US

IV. Provider business mailing address

5006 ANTOINE PL
PENSACOLA FL
32505-3467
US

V. Phone/Fax

Practice location:
  • Phone: 850-980-0034
  • Fax:
Mailing address:
  • Phone: 850-980-0034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: AMANDA JONES
Title or Position: OWNER/CMO
Credential: DC,CCSP
Phone: 251-597-2700