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General NPI Number Information
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NPI Number | 1508092958
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Entity Type | Individual
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Provider Name | AUTUMN LYNN MONTEIRO D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 6090 S FORT APACHE RD #100
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City | LAS VEGAS
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State | NV
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Zip | 89148-5617
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Country | US
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Telephone | 702-591-5610
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Fax |
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Provider Business Mailing Address
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Address Line | 8945 DIAMOND FALLS DR
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City | LAS VEGAS
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State | NV
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Zip | 89117-5701
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Country | US
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Telephone | 702-591-5610
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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 | B01328
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License Number State | NV
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