Individual
MRS. MARYALICE MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN CNOR RNFA
Contact information
Practice address
21309 LOWLAND AVE, EAGLE RIVER, AK 99577-9565
(907) 622-6222
Mailing address
21309 LOWLAND AVE, EAGLE RIVER, AK 99577-9565
(907) 622-6222
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
24088
AK
Other
Enumeration date
10/31/2008
Last updated
10/31/2008
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