Most Relevant Information
Provider Data
| NPI Number: | 1003389248 |
| Provider Name: | SONIMARIE H MONTGOMERY |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 13215 |
Most Important Dates
| Enumeration Date: | 01/10/2019 |
| Last Updated: | 01/10/2019 |
Provider Practice Location
2590 WOODLAND DR
COOS BAY
OR
974202050
Practice Location Phone/Fax
| Phone: | 5033301715 |
| Fax: | 5418080399 |
Provider Mailing Location
95041 STOCK SLOUGH LN
COOS BAY
OR
974206348
Provider Mailing Phone/Fax
| Phone: | 5033301715 |
| Fax: | 5418080399 |