Individual
GRACIE MONTANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31889 CALLE LUZ, TEMECULA, CA 92592-3926
(855) 832-6727
Mailing address
49900 COPPERIDGE ST, COACHELLA, CA 92236-5375
(760) 296-8732
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
CA
Other
Enumeration date
09/17/2020
Last updated
09/21/2020
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