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General NPI Number Information
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NPI Number | 1063147585
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Entity Type | Individual
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Provider Name | DEBORAH MONTOYA MMP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 14021 N 51ST AVE STE 102
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City | GLENDALE
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State | AZ
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Zip | 85306-4839
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Country | US
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Telephone | 623-777-9475
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Fax |
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Provider Business Mailing Address
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Address Line | 4440 W PORT AU PRINCE LN
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City | GLENDALE
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State | AZ
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Zip | 85306-3628
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Country | US
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Telephone | 614-599-2436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 22047
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License Number State | AZ
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