Individual
JASON MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-2580
(208) 239-2580
Mailing address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-2580
(208) 239-2580
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1182A
ID
Other
Enumeration date
06/19/2012
Last updated
06/21/2016
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