Individual
ALONZO MONTEZ THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
42 WAYNE ST, BLOOMINGBURG, OH 43106-9009
(937) 600-2781
Mailing address
42 WAYNE ST, BLOOMINGBURG, OH 43106-9009
(937) 600-2781
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17500000X
PEER SPECIALIST
OH
Enumeration date
03/07/2022
Last updated
03/07/2022
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