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General NPI Number Information
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NPI Number | 1285002709
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Entity Type | Organization
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Legal Business Name | RST & MONTGOMERY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 2335 ATHENS AVE
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City | REDDING
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State | CA
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Zip | 96001-2818
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Country | US
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Telephone | 530-247-4228
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Fax | 530-247-4275
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Provider Business Mailing Address
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Address Line | 2335 ATHENS AVE
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City | REDDING
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State | CA
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Zip | 96001-2818
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Country | US
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Telephone | 530-247-4228
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Fax | 530-247-4275
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Authorized Official
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Title or Position | OWNER, BUSINESS MANAGER
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Name | MRS. HEALOHANANI MONTGOMERY
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Credential |
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Telephone | 530-247-4228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 31642
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License Number State | CA
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