Individual
DR. AMIKO SUE FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1950 SPECTRUM CIR SE STE 400, MARIETTA, GA 30067-1638
(678) 541-4357
Mailing address
13660 N 94TH DR STE C4, PEORIA, AZ 85381-4841
(602) 502-2319
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8118
AZ
111N00000X
Chiropractor
CHIR008451
GA
Other
Enumeration date
05/18/2009
Last updated
05/17/2010
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