Organization
MONTGOMERY CHIROPRACTIC WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICK MONTGOMERY D.C. (PRESIDENT)
(812) 424-7823
Entity
Organization
Contact information
Practice address
3818 NORTH 1ST AVE, EVANSVILLE, IN 47710-3326
(812) 424-7823
Mailing address
3818 NORTH 1ST AVE, EVANSVILLE, IN 47710-3326
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002119A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340468
BLUE SHIELD
IN
05
—
200488140
—
IN
Enumeration date
05/11/2007
Last updated
10/06/2008
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