Individual
TAMARA MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13549 N SANDERS RD, MARANA, AZ 85653-9505
(520) 682-1095
(520) 682-4132
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4560
(520) 682-4570
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP043753
AZ
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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