Provider Demographics
NPI:1346064052
Name:PRENTICE, AMY CLAIRE (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:CLAIRE
Last Name:PRENTICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-8608
Mailing Address - Country:US
Mailing Address - Phone:214-926-6784
Mailing Address - Fax:
Practice Address - Street 1:422 I 30 E STE D
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-9701
Practice Address - Country:US
Practice Address - Phone:972-968-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor