Provider Demographics
NPI:1386873974
Name:CONNELLY, AMANDA BINDER (DC)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:BINDER
Last Name:CONNELLY
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 1:2170 W STATE ROAD 434 STE 252
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4976
Mailing Address - Country:US
Mailing Address - Phone:407-331-9913
Mailing Address - Fax:407-331-9918
Practice Address - Street 1:2170 W STATE ROAD 434 STE 252
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4976
Practice Address - Country:US
Practice Address - Phone:407-331-9913
Practice Address - Fax:407-331-9918
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor