Doctor Name: | CHRIS MONTZ |
NPI Number: | 1588031413 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ABOC |
License Number: | 166713 |
Business Practice Address: | 23050 Mcauliffe Dr Robertsdale, AL - 365673122 |
Business Phone Number: | 2519474300 |
Business Fax Number: | 2519474365 |
Mailing Address: | 23050 Mcauliffe Dr, ROBERTSDALE |
State: | AL |
Postal Code: | 365673122 |
Phone Number: | 2519474300 |
Fax Number: | 2519474365 |
NPI Enumeration Date: | 08/26/2015 |
NPI Last Update Date: | 08/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 166713 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |