Healthcare Provider Details

I. General information

NPI: 1073243051
Provider Name (Legal Business Name): ABRIAN MONTOYA CPT,CES,FNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 CANDELARIA RD NE STE B
ALBUQUERQUE NM
87107-1966
US

IV. Provider business mailing address

3321 CANDELARIA RD NE STE B
ALBUQUERQUE NM
87107-1966
US

V. Phone/Fax

Practice location:
  • Phone: 505-400-0218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: