Tom Montgomery III

NPI 1205225117 - Nursing Home Administrator - 376G00000X

NPI Details
NPI 1205225117
Gender Male
Enumeration Date 01/15/2015
Last Updated 01/15/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
1929 BETTY JANE LN
MUSKOGEE OK, 74403-1581, US
Phone (918) 683-9407
Fax
Business Location
1929 BETTY JANE LN
MUSKOGEE OK, 74403-1581, US
Phone (918) 683-9407
Fax
Toxanomy
Taxonomy Code 376G00000X
License State Oklahoma
License Number 2286
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According to our database, Mr. Tom Montgomery III NPI is 1205225117, taxonomy code is 376G00000X and license number is 2286, license state is located at Oklahoma. Tom Montgomery III physically located at 1929 Betty Jane Ln, Muskogee OK, 74403-1581. NPI Number Tom Montgomery III has the Individual type.

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1205225117 NPI number is provided on an as is basis without warranty of any kind. 1205225117 is maintained by the National Plan & Provider Enumeration System. The contents of Tom Montgomery III are for informational purposes only.