Healthcare Provider Details

I. General information

NPI: 1083418164
Provider Name (Legal Business Name): AMANDA ELIZABETH BROWN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 LANIER BLVD NE SUITE #1409-A
ATLANTA GA
30306
US

IV. Provider business mailing address

1390 LANIER BLVD NE SUITE #1409-A
ATLANTA GA
30306
US

V. Phone/Fax

Practice location:
  • Phone: 404-860-1030
  • Fax:
Mailing address:
  • Phone: 404-860-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCHIR011378
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: