Organization
BIG PARK FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TY MONTGOMERY NP (OWNER)
(928) 300-4783
Entity
Organization
Contact information
Practice address
61 BELL ROCK PLZ, SEDONA, AZ 86351-8810
(928) 300-4783
(928) 634-0337
Mailing address
PO BOX 21540, SEDONA, AZ 86341-1540
(928) 300-4783
(928) 634-0337
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP2648
AZ
Other
Enumeration date
06/13/2007
Last updated
11/07/2007
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