=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558332478
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA RENEE FRANCIS D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10655 HIGHWAY 21
-----------------------------------------------------
City | HILLSBORO
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63050-5094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-789-2287
-----------------------------------------------------
Fax | 636-789-3371
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10655 HIGHWAY 21
-----------------------------------------------------
City | HILLSBORO
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63050-5094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-789-2287
-----------------------------------------------------
Fax | 636-789-3371
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2004027861
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------