Provider Demographics
NPI:1194926477
Name:SIMPSON, AMBER (DC)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:MILLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:259 HIGHWAY J
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-2227
Mailing Address - Country:US
Mailing Address - Phone:636-462-5700
Mailing Address - Fax:636-462-5700
Practice Address - Street 1:259 HIGHWAY J
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-2227
Practice Address - Country:US
Practice Address - Phone:636-462-5700
Practice Address - Fax:636-462-5700
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002001054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000032154OtherMEDICARE PTAN
000032154OtherMEDICARE PTAN