Provider Demographics
NPI:1508033978
Name:MONAGAN, ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MONAGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12202 WINDRIVER LN
Mailing Address - Street 2:#13
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8904
Mailing Address - Country:US
Mailing Address - Phone:727-857-6191
Mailing Address - Fax:
Practice Address - Street 1:12202 WINDRIVER LN
Practice Address - Street 2:#13
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-8904
Practice Address - Country:US
Practice Address - Phone:727-857-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR-6481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor