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General NPI Number Information
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NPI Number | 1104461011
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Entity Type | Individual
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Provider Name | AUSTIN RICO DC
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Gender | Male
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 991 CASS ST
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City | MONTEREY
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State | CA
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Zip | 93940-4517
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Country | US
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Telephone | 831-241-3203
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Fax |
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Provider Business Mailing Address
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Address Line | 26087 DICHRO DR
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City | CARMEL
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State | CA
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Zip | 93923-8908
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Country | US
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Telephone | 831-241-3203
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 34439
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License Number State | CA
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