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General NPI Number Information
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NPI Number | 1548413040
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Entity Type | Individual
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Provider Name | AMANDA HANEY OD
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Gender | Female
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 1407 W 84TH AVE UNIT B8
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City | DENVER
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State | CO
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Zip | 80260
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Country | US
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Telephone | 720-214-4746
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Fax | 720-214-4751
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Provider Business Mailing Address
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Address Line | 2221 E BIJOU ST STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-8009
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Country | US
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Telephone | 719-576-1850
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Fax | 719-955-3470
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2655
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License Number State | CO
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