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Individual

JOHN PAUL MONTANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1313 N MAIZE CT, #208, WICHITA, KS 67212-4388
(316) 721-5036
(316) 721-1705
Mailing address
1313 N MAIZE CT, #208, WICHITA, KS 67212-4388
(316) 721-5036

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115011
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115011
KS
Enumeration date
10/21/2014
Last updated
10/21/2014
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