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NPI Code Detail

MEDICARE: MONTGOMERY MEDICAL CLINIC INC

MEDICARE: MONTGOMERY MEDICAL CLINIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1275769333
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONTGOMERY MEDICAL CLINIC INC
Provider Business Mailing Address
First Line : 7112 UNIVERSITY CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-8045
Country : US
Telephone Number : 334-215-9160
Fax Number : 334-215-9163
Provider Business Practice Location Address
First Line : 7112 UNIVERSITY CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-8045
Country : US
Telephone Number : 334-215-9160
Fax Number : 334-215-9163
Authorized Official
Title or Position : PRESIDENT
Name : SAUL ZACETA
Credential :
Telephone Number : 334-215-9160
Provider Enumeration Date : 06/03/2009
Last Update Date : 06/03/2009

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Directions to “MONTGOMERY MEDICAL CLINIC INC ” Practice Location

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