Individual
MR. JERRY R MONTOYA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1501 SAN PEDRO SE, ALBUQUERQUE, NM 87108-9874
(505) 265-1711
(505) 256-2747
Mailing address
HC 66-196-3, MOUNTAINAIR, NM 87036
(505) 265-1711
(505) 256-2747
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
80-PA011
NM
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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