Individual
MARK MONTOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
4112 OUTLOOK BLVD, PUEBLO, CO 81008-1667
(719) 553-1051
Mailing address
4112 OUTLOOK BLVD, PUEBLO, CO 81008-1667
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12116
CO
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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