Individual
AVERIE MONTGOMERY-DIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
2538 CAMINO ENTRAD SUITE 300, SANTA FE, NM 87507
(505) 424-1239
Mailing address
2538 CAMINO ENTRADA STE 300, SANTA FE, NM 87507-4927
(505) 424-1239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1328
NM
225700000X
Massage Therapist
4837
NM
Other
Enumeration date
11/16/2017
Last updated
04/23/2018
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