Individual
MONTANA PAGANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 SW 1ST ST, ENTERPRISE, OR 97828-1203
(541) 426-4524
Mailing address
207 SW 1ST ST, ENTERPRISE, OR 97828-1203
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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