Individual
MRS. COLLEEN ALETHA MONTAQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2926 MILL PARK CT, DACULA, GA 30019-3254
(347) 678-2865
Mailing address
2926 MILL PARK CT, DACULA, GA 30019-3254
(347) 678-2865
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN221313
GA
207Q00000X
Family Medicine Physician
RN221313
GA
207VG0400X
Gynecology Physician
RN221313
GA
Other
Enumeration date
07/31/2018
Last updated
12/07/2023
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