Individual
EUGENE MONTALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 739-4973
(203) 739-4912
Mailing address
17826 24TH AVENUE CT E, TACOMA, WA 98445-4220
(253) 353-6260
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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