Individual
MRS. MARIETTA MONTOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
129 CANAL STREET, JEMEZ PUEBLO, NM 87024
(505) 834-3175
(505) 834-0238
Mailing address
6820 VIVIAN DR NE, ALBUQUERQUE, NM 87109-4047
(505) 858-3011
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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