Healthcare Provider Details

I. General information

NPI: 1518870120
Provider Name (Legal Business Name): DENA JEANE MONTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E MONROE AVE
MCALESTER OK
74501-4815
US

IV. Provider business mailing address

100 WANDERING TRL
MCALESTER OK
74501-6073
US

V. Phone/Fax

Practice location:
  • Phone: 918-426-7800
  • Fax:
Mailing address:
  • Phone: 918-426-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number213815
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: