Individual
KIZUWANDA MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11351 W ALICE AVE, PEORIA, AZ 85345-3422
(623) 451-2249
Mailing address
11351 W ALICE AVE, PEORIA, AZ 85345-3422
(623) 451-2249
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
08/23/2022
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