Provider Demographics
NPI:1316939366
Name:OSENBAUGH, AMY SUE (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:SUE
Last Name:OSENBAUGH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:OSENBAUGH-PORTERFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:117 NE TRILEIN DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-2082
Mailing Address - Country:US
Mailing Address - Phone:515-965-7835
Mailing Address - Fax:515-965-8009
Practice Address - Street 1:117 NE TRILEIN DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-2082
Practice Address - Country:US
Practice Address - Phone:515-965-7835
Practice Address - Fax:515-965-8009
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA53900Medicare ID - Type Unspecified