MEDICARE: MONTOYA M CHRISTIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	2279G0305X	Geriatric Care Registered Respiratory Therapist
2	1041C0700X	Clinical Social Worker
3	376K00000X	Nurse's Aide
4	374U00000X	Home Health Aide	NC

General Provider Information

NPI Number	:	1588226799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONTOYA M CHRISTIAN

Provider Business Mailing Address
First Line	:	10926 DAVID TAYLOR DRIVE
Second Line	:	SUITE 120
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1042
Country	:	US
Telephone Number	:	980-322-7279
Fax Number	:	866-908-6945

Provider Business Practice Location Address
First Line	:	10926 DAVID TAYLOR DRIVE
Second Line	:	SUITE 120
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1042
Country	:	US
Telephone Number	:	980-322-7279
Fax Number	:	866-908-6945

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2019
Last Update Date	:	07/08/2019

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Directions to “ MONTOYA M CHRISTIAN ” Practice Location

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