Individual
JASON T MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
476 N 900 W, SUITE C, AMERICAN FORK, UT 84003-5199
(801) 492-1611
(801) 492-1480
Mailing address
PO BOX 8476, BELFAST, ME 04915-8476
(801) 542-8222
(801) 542-8227
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6743553-1206
UT
Other
Enumeration date
12/05/2007
Last updated
11/04/2021
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