Individual
MCKENSIE S MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(575) 624-8170
Mailing address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(575) 624-8170
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
P-0065
NM
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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