Individual
MONTOYA DEMONT GUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1801 FULLER RD, SUITE A-01, MERIDIAN, MS 39309-5106
(601) 679-3973
Mailing address
3007 12TH AVE, MERIDIAN, MS 39305-4820
(910) 389-6914
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/29/2007
Last updated
11/10/2009
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