Provider Demographics
NPI:1194836718
Name:MONTZKA, DEBORAH KAY (DC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:MONTZKA
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:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:PARK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56470-0007
Mailing Address - Country:US
Mailing Address - Phone:218-237-3771
Mailing Address - Fax:218-237-2311
Practice Address - Street 1:1202 1ST ST E
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470-1849
Practice Address - Country:US
Practice Address - Phone:218-237-3771
Practice Address - Fax:218-237-2311
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN03063HEOtherBCBS
MN384823000OtherMEDICAL ASSISTANCE
MNU53964Medicare UPIN
MN384823000OtherMEDICAL ASSISTANCE
U53964Medicare UPIN