Individual
MR. JONATHAN RAY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP, BC
Contact information
Practice address
4088 W 1820 S, SALT LAKE CITY, UT 84104-4801
(801) 975-7799
Mailing address
14344 CROWN ROSE DR, HERRIMAN, UT 84096-6927
(801) 302-5976
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
331062-4405
UT
Other
Enumeration date
10/02/2006
Last updated
12/29/2008
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