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General NPI Number Information
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NPI Number | 1437430386
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Entity Type | Individual
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Provider Name | MANUEL MONTANO ARAGON LMT
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Gender | Male
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 568 NE SAVANNAH DR STE 5
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City | BEND
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State | OR
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Zip | 97701-4866
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Country | US
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Telephone | 949-375-7278
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Fax |
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Provider Business Mailing Address
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Address Line | 2660 NE HIGHWAY 20 STE 610-447
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City | BEND
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State | OR
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Zip | 97701-6402
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Country | US
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Telephone | 949-375-7278
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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 | LMT-24958
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | CAMTC 20733
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License Number State | CA
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