Individual
DAVID MONTIJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-1768
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
—
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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