Individual
BLAINE K MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
819 E MARKETPLACE DRIVE, SPANISH FORK, UT 84660-2060
(801) 717-0341
Mailing address
819 E MARKETPLACE DRIVE, SPANISH FORK, UT 84660-2060
(801) 717-0341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9508541-1206
UT
Other
Enumeration date
09/16/2015
Last updated
11/01/2021
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