IndividualActive
Blake Montgomery, PA-C
NPI 1376223818 · Physician Assistant · West Valley, UT
Provider details
- NPI number
- 1376223818
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 8747490-1206 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1681 W 3860 S Ste 106b
West Valley, UT 84119-6274
Phone: (385) 429-0785
Approximate (ZIP-level) locationGet directions
Mailing address
1681 W 3860 S Ste 106b
West Valley, UT 84119-6274
Registry dates
- Enumerated
- 2023-07-19
- Last updated
- 2023-07-19
- Certified
- 2023-07-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.