Provider Demographics
NPI:1720032501
Name:MONTERO, HUMBERTO SR (DC)
Entity Type:Individual
Prefix:MR
First Name:HUMBERTO
Middle Name:
Last Name:MONTERO
Suffix:SR
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 1:1881 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-5619
Mailing Address - Country:US
Mailing Address - Phone:928-782-2233
Mailing Address - Fax:928-782-2001
Practice Address - Street 1:1881 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-5619
Practice Address - Country:US
Practice Address - Phone:928-782-2233
Practice Address - Fax:928-782-2001
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4290111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology