Provider Demographics
NPI:1215361464
Name:BRANDIS, AMANDA CHRISTINE (LAC, DIPL AC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:BRANDIS
Suffix:
Gender:F
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CHRISTINE
Other - Last Name:RUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1107 BARNBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-1977
Mailing Address - Country:US
Mailing Address - Phone:215-206-2607
Mailing Address - Fax:
Practice Address - Street 1:184 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-2049
Practice Address - Country:US
Practice Address - Phone:215-206-2607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001089171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist