Montgomery, Blake William
Montgomery, Blake William is an individual health care provider with primary practice located at 1681 W 3860 S Ste 106B , West Valley UT 84119-6274. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Montgomery, Blake William can be contacted via phone (385) 429-0785.Contact Information
Primary practice address
1681 W 3860 S Ste 106B
West Valley UT 84119-6274
Phone: (385) 429-0785
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 8747490-1206 | Utah |
Profile Details
| NPI number | 1376223818 |
|---|---|
| LBN Legal business name | Montgomery, Blake William |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2023 |
| Last updated | Jul 19th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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