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General NPI Number Information
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NPI Number | 1457887549
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Entity Type | Individual
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Provider Name | MONTE AUKES
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Gender | Male
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 109 N 3RD ST
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City | NILES
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State | MI
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Zip | 49120-2655
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Country | US
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Telephone | 269-357-3351
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Fax |
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Provider Business Mailing Address
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Address Line | 536 LAKE ST
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City | NILES
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State | MI
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Zip | 49120-1770
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Country | US
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Telephone | 269-357-3351
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 7501000973
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License Number State | MI
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