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General NPI Number Information
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NPI Number | 1669910253
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Entity Type | Organization
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Legal Business Name | MONTROSE CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 201 S 3RD ST
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City | MONTROSE
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State | CO
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Zip | 81401-3617
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Country | US
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Telephone | 970-249-5551
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Fax | 970-249-8690
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Provider Business Mailing Address
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Address Line | 201 S 3RD ST
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City | MONTROSE
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State | CO
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Zip | 81401-3617
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Country | US
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Telephone | 970-249-5551
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Fax | 970-249-8690
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN TIMOTHY UNGER
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Credential | D.C.
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Telephone | 970-249-5551
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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 | 2495
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License Number State | CO
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