Doctor Name: | JOHN S MONTGOMERY |
NPI Number: | 1023073483 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 1821991205 |
Business Practice Address: | 575 East 100 South Price, UT - 84501 |
Business Phone Number: | 4356372358 |
Business Fax Number: | 4356379141 |
Mailing Address: | Po Box 867, 105 West 100 North PRICE |
State: | UT |
Postal Code: | 84501 |
Phone Number: | 4356377200 |
Fax Number: | 4356372377 |
NPI Enumeration Date: | 04/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 1821991205 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | UT |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |