| Doctor Name: | DR. AMIKO SUE FOUNTAIN |
| NPI Number: | 1073748273 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DC |
| License Number: | CHIR008451 |
| Business Practice Address: | 1950 Spectrum Cir Se Ste 400 Marietta, GA - 300671638 |
| Business Phone Number: | 6785414357 |
| Business Fax Number: | |
| Mailing Address: | 13660 N 94th Dr Ste C4, PEORIA |
| State: | AZ |
| Postal Code: | 853814841 |
| Phone Number: | 6025022319 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2009 |
| NPI Last Update Date: | 05/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | CHIR008451 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |