Individual
MR. MONTY OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4323 E BROADWAY RD, SUITE 106, MESA, AZ 85206-3506
(480) 854-9833
(480) 854-9834
Mailing address
1823 S ESSEX CIR, MESA, AZ 85209-4015
(480) 415-0744
(480) 854-9834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2989
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0297810
BCBS
AZ
Enumeration date
11/14/2006
Last updated
07/08/2007
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