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Individual
WARREN R MONTGOMERY
Active
Individual
WARREN R MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0030984
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000356
—
VT
Enumeration date
02/06/2006
Last updated
01/25/2016
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