Provider Demographics
NPI:1376704551
Name:KRISTY MONTZ CHIROPRACTOR P C
Entity Type:Organization
Organization Name:KRISTY MONTZ CHIROPRACTOR P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MONTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-847-5081
Mailing Address - Street 1:605 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65625-1419
Mailing Address - Country:US
Mailing Address - Phone:417-847-5081
Mailing Address - Fax:
Practice Address - Street 1:605 MAIN ST
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65625-1419
Practice Address - Country:US
Practice Address - Phone:417-847-5081
Practice Address - Fax:417-847-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty