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General NPI Number Information
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NPI Number | 1275908121
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Entity Type | Organization
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Legal Business Name | MONARCH CHIROPRACTIC
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 250 BEL MARIN KEYS BLVD STE D1
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City | NOVATO
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State | CA
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Zip | 94949-5709
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Country | US
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Telephone | 415-612-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 250 BEL MARIN KEYS BLVD STE D1
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City | NOVATO
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State | CA
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Zip | 94949-5709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MONICA KNOWLES
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Credential | D.C.
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Telephone | 415-612-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number | 31715
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License Number State | CA
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