MEDICARE: DR. AMANDA MARIE THORNTON AU. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	8013696-4101	UT

General Provider Information

NPI Number	:	1467736306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA MARIE THORNTON AU. D.

Provider Business Mailing Address
First Line	:	9300 DEWITT LOOP
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-5285
Country	:	US
Telephone Number	:	571-231-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	9300 DEWITT LOOP, SUNRISE PAVILION, SECOND FLOOR
Second Line	:	FORT BELVOIR COMMUNITY HOSPITAL
City	:	FORT BELVIOR
State	:	VA
Zip	:	22060-1298
Country	:	US
Telephone Number	:	571-231-2725
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2011
Last Update Date	:	06/25/2024

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