Provider Demographics
NPI:1720733173
Name:BROWN, AMANDA SAVOIA (CO)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:SAVOIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10320 FELD FARM LN STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8484
Mailing Address - Country:US
Mailing Address - Phone:704-707-0014
Mailing Address - Fax:704-707-0017
Practice Address - Street 1:10320 FELD FARM LN STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8484
Practice Address - Country:US
Practice Address - Phone:704-707-0014
Practice Address - Fax:704-707-0017
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO006445222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO006445OtherABC CERTIFIED ORTHOTIST (CO)