Healthcare Provider Details

I. General information

NPI: 1972419356
Provider Name (Legal Business Name): DAVIN BLANE MONTOYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2343 EAGLE DR STE A
PAGOSA SPRINGS CO
81147-9058
US

IV. Provider business mailing address

2343 EAGLE DR STE A
PAGOSA SPRINGS CO
81147-9058
US

V. Phone/Fax

Practice location:
  • Phone: 970-903-5237
  • Fax: 970-317-2537
Mailing address:
  • Phone: 970-903-5237
  • Fax: 970-317-2537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: