Provider Demographics
NPI:1689720252
Name:MONTGOMERY, CURTIS W (DC)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:W
Last Name:MONTGOMERY
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 1:6927 BROCKTON AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506
Mailing Address - Country:US
Mailing Address - Phone:951-782-8369
Mailing Address - Fax:951-782-8378
Practice Address - Street 1:6927 BROCKTON AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506
Practice Address - Country:US
Practice Address - Phone:951-782-8369
Practice Address - Fax:951-782-8378
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0247490111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor