Healthcare Provider Details

I. General information

NPI: 1265477038
Provider Name (Legal Business Name): RICHARD G DEMONT PHD, ATC, CAT(C)
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7141 SHERBROOKE ST W
MONTREAL QC
H4B1R6
CA

IV. Provider business mailing address

7318 SHERBROOKE ST W
MONTREAL QC
H4B1R7
CA

V. Phone/Fax

Practice location:
  • Phone: 514-848-2424
  • Fax: 514-848-8681
Mailing address:
  • Phone: 514-848-2424
  • Fax: 514-848-8681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: