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Individual

CAROL SUE MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
JCT. HWY 160 & NAVAJO ROUTE 35 - RED MESA, TEEC NOS POS, AZ 86514
(928) 656-5164
Mailing address
HCR 6100 BOX 30, TEEC NOS POS, AZ 86514
(928) 656-5000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
677859
CA

Other

Enumeration date
06/23/2010
Last updated
06/23/2010
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