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Individual

GEORGIA N MONTGOMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OWNER

Contact information

Practice address
1020 SAN PEDRO DR NE, ALBUQUERQUE, NM 87110-6722
(505) 256-9587
(505) 266-2484
Mailing address
1020 SAN PEDRO DR NE, ALBUQUERQUE, NM 87110-6722
(505) 256-9587
(505) 266-2484

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
75077311
NM
Enumeration date
07/12/2006
Last updated
07/08/2007
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