Individual
MARY LOU MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1952 S MANZANITA TRL, COTTONWOOD, AZ 86326-5758
(928) 772-4131
Mailing address
1952 S MANZANITA TRL, COTTONWOOD, AZ 86326-5758
(928) 772-4131
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2209959
AZ
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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