Individual
MS. AVAYETTA M. MONTGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1322 E 8TH ST, PUEBLO, CO 81001-3512
(719) 542-4801
Mailing address
1322 E 8TH ST, PUEBLO, CO 81001-3512
(719) 542-4801
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12803
CO
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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