Provider Demographics
NPI:1780793570
Name:MONTANO, JOHN A (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:MONTANO
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 1:1512 W BELL RD
Mailing Address - Street 2:#4
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023
Mailing Address - Country:US
Mailing Address - Phone:602-375-1781
Mailing Address - Fax:602-548-6900
Practice Address - Street 1:1512 W BELL RD
Practice Address - Street 2:#4
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023
Practice Address - Country:US
Practice Address - Phone:602-375-1781
Practice Address - Fax:602-548-6900
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5142111N00000X
AZ2877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ400606Medicaid
AZ623422OtherACN
AZA20239100OtherBCBS
AZA20239100OtherBCBS
AZ400606Medicaid