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General NPI Number Information
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NPI Number | 1508732645
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Entity Type | Individual
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Provider Name | BIANCA CRYSTAL MONTALVO OD
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Gender | Female
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1815 E HIGHLAND DR
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City | JONESBORO
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State | AR
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Zip | 72401-6118
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Country | US
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Telephone | 870-931-2020
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Fax | 870-932-8004
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Provider Business Mailing Address
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Address Line | 1815 E HIGHLAND DR
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City | JONESBORO
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State | AR
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Zip | 72401-6118
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Country | US
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Telephone | 870-931-2020
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Fax | 870-932-8004
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2894
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License Number State | AR
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