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Individual
MS. LAVERNE S MONTGOMERY
Active
Individual
MS. LAVERNE S MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,RD, LD
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
LD000993
GA
133V00000X
Registered Dietitian
Primary
LD000993
GA
Other
Enumeration date
09/24/2006
Last updated
11/07/2016
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