Provider Demographics
NPI:1154471522
Name:MONTEIRO, JOANN (DC)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:MONTEIRO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 ARCADE AVE
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-3244
Mailing Address - Country:US
Mailing Address - Phone:508-336-0929
Mailing Address - Fax:508-336-0701
Practice Address - Street 1:572 ARCADE AVE
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-3244
Practice Address - Country:US
Practice Address - Phone:508-336-0929
Practice Address - Fax:508-336-0701
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH 1883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1612328Medicaid
MAY36350Medicare ID - Type Unspecified
MA1612328Medicaid
MA351082Medicare UPIN