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NPI Code Detail

MEDICARE: AUTUMN L MONTEIRO, DC A PROFESSIONAL CORPORATION

MEDICARE: AUTUMN L MONTEIRO, DC A PROFESSIONAL CORPORATION
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
1111N00000XChiropractorB01328NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11508092958OTHERNVTYPE 1 NPI

General Provider Information

NPI Number : 1881938413
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTUMN L MONTEIRO, DC A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 6090 S FORT APACHE RD
Second Line : #100
City : LAS VEGAS
State : NV
Zip : 89148-5658
Country : US
Telephone Number : 702-834-5777
Fax Number : 702-442-0755
Provider Business Practice Location Address
First Line : 6090 S FORT APACHE RD
Second Line : #100
City : LAS VEGAS
State : NV
Zip : 89148-5658
Country : US
Telephone Number : 702-834-5777
Fax Number : 702-442-0755
Authorized Official
Title or Position : PRESIDENT
Name : DR. AUTUMN L MONTEIRO
Credential : D.C.
Telephone Number : 702-834-5777
Provider Enumeration Date : 11/20/2012
Last Update Date : 11/20/2012

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