Provider Demographics
NPI:1578744512
Name:MONITTO, PAUL W (DC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:MONITTO
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 1:206 MERRIMON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1230
Mailing Address - Country:US
Mailing Address - Phone:828-252-7400
Mailing Address - Fax:828-252-7370
Practice Address - Street 1:206 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1230
Practice Address - Country:US
Practice Address - Phone:828-252-7400
Practice Address - Fax:828-252-7370
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1238111N00000X
GA1662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908631Medicaid
NC244358Medicare PIN
NC8908631Medicaid