Healthcare Provider Details
I. General information
NPI: 1912849670
Provider Name (Legal Business Name): MICHAEL MONTROSS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2635 N 7TH ST
GRAND JUNCTION CO
81501-8209
US
IV. Provider business mailing address
7501 E MCDOWELL RD APT 2059
SCOTTSDALE AZ
85257-3564
US
V. Phone/Fax
- Phone: 970-298-2273
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: