Michael R Montgomery OD

NPI 1124002969 - Optometrist - 152W00000X

NPI Details
NPI 1124002969
Gender Male
Enumeration Date 12/05/2005
Last Updated 11/27/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
279 E ELM ST
LEBANON MO, 65536-3610, US
Phone (417) 532-2562
Fax (417) 532-2409
Business Location
279 E ELM ST
LEBANON MO, 65536-3610, US
Phone (417) 532-2562
Fax (417) 532-2409
Toxanomy
Taxonomy Code 152W00000X
License State Missouri
License Number T02552
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According to our database, Dr. Michael R Montgomery OD NPI is 1124002969, taxonomy code is 152W00000X and license number is T02552, license state is located at Missouri. Michael R Montgomery OD physically located at 279 E Elm St, Lebanon MO, 65536-3610. NPI Number Michael R Montgomery OD has the Individual type.

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1124002969 NPI number is provided on an as is basis without warranty of any kind. 1124002969 is maintained by the National Plan & Provider Enumeration System. The contents of Michael R Montgomery OD are for informational purposes only.