Provider Demographics
NPI:1336856343
Name:CORDERO RAMOS, NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:CORDERO RAMOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S 44TH ST W APT 1305
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3948
Mailing Address - Country:US
Mailing Address - Phone:787-221-7465
Mailing Address - Fax:
Practice Address - Street 1:851 SHILOH CROSSING BLVD STE 4
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7355
Practice Address - Country:US
Practice Address - Phone:406-534-6465
Practice Address - Fax:406-534-6722
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-7382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor