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Organization
GULF COAST PAIN CONSULTANTS LLC
Active
Organization
GULF COAST PAIN CONSULTANTS LLC
Active
Other names
Clearway Pain Solutions Institute
Organization subpart
No
Provider details
NPI number
Authorized official
KACEY MONTGOMERY MD (MEDICAL DIRECTOR)
(850) 791-6895
Entity
Organization
Contact information
Practice address
182 A EAST REDSTONE AVE, CRESTVIEW, FL 32539-5371
(850) 484-4080
(850) 484-8801
Mailing address
201 DEFENSE HWY STE 205, ANNAPOLIS, MD 21401-7096
(855) 527-7246
(833) 810-1165
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
01/31/2023
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