Individual
WYATT MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1755 N 200 E, LOGAN, UT 84341-1915
(435) 753-6245
Mailing address
971 S 800 W, BRIGHAM CITY, UT 84302-3042
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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