MEDICARE: DR. MONTE J PENROD D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3528	NC

General Provider Information

NPI Number	:	1326028267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONTE J PENROD D.C.

Provider Business Mailing Address
First Line	:	409 FOX RUN LN
Second Line	:
City	:	TRYON
State	:	NC
Zip	:	28782-6701
Country	:	US
Telephone Number	:	828-817-9252
Fax Number	:	828-859-7649

Provider Business Practice Location Address
First Line	:	409 FOX RUN LN
Second Line	:
City	:	TRYON
State	:	NC
Zip	:	28782-6701
Country	:	US
Telephone Number	:	828-817-9252
Fax Number	:	828-859-7649

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/14/2009

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