Individual
MARISSA MONTEZUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1510 BYRUM RD, BLYTHEVILLE, AR 72315-8033
(870) 824-8668
Mailing address
1510 BYRUM RD, BLYTHEVILLE, AR 72315-8033
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
121074
AR
Other
Enumeration date
05/07/2024
Last updated
05/14/2024
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