Individual
MICHELLE M MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
3350 W AMERICANA TER STE 215, BOISE, ID 83706-2545
(208) 615-2448
(208) 328-5535
Mailing address
14924 DAGGER FALLS WAY, CALDWELL, ID 83607-5457
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-699
ID
133V00000X
Registered Dietitian
LD-D-10147007
OR
Other
Enumeration date
01/13/2022
Last updated
01/13/2022
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