Provider Demographics
NPI:1700932811
Name:MONTANEZ, SAMANTHA MONTANEZ
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:MONTANEZ
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 REDWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-4815
Mailing Address - Country:US
Mailing Address - Phone:785-770-8915
Mailing Address - Fax:785-537-9943
Practice Address - Street 1:414 REDWOOD PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4815
Practice Address - Country:US
Practice Address - Phone:785-770-8915
Practice Address - Fax:785-537-9943
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management