Provider Demographics
NPI:1750447462
Name:CHIROPRACTIC MOBILE EXAMINERS, LLC
Entity type:Organization
Organization Name:CHIROPRACTIC MOBILE EXAMINERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MONTALBANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:484-256-4832
Mailing Address - Street 1:2804 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TROOPER
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1503
Mailing Address - Country:US
Mailing Address - Phone:484-256-4832
Mailing Address - Fax:
Practice Address - Street 1:311 W JOHNSON HWY UNIT 6A
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-1992
Practice Address - Country:US
Practice Address - Phone:484-256-4832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007912L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty