Basic Information
| Provider Information | |||||||||
| NPI: | 1093737348 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MONTEAGUDO | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 NELSON ST | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023604045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177509755 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 75 FINNELL DR | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021881110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816829755 | ||||||||
| FaxNumber: | 7813357851 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 01/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 3021 | MA | Y | Chiropractic Providers | Chiropractor |
No ID Information.