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Individual

ERIN J MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10798 W OVERLAND RD, BOISE, ID 83709-1329
(208) 377-3368
(208) 322-4691
Mailing address
10798 W OVERLAND RD, BOISE, ID 83709-1329
(208) 377-3368
(208) 322-4691

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1446
ID
363AM0700X
Medical Physician Assistant
PA198079
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1245782416
ID
05
500762276
OR
Enumeration date
11/03/2016
Last updated
01/22/2024
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