Organization
WHITE OWL RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STACEY MONTGOMERY RHIT, CPMA, CPC (MANAGING PARTNER)
(859) 229-4647
Entity
Organization
Contact information
Practice address
8699 S US HIGHWAY 25, CORBIN, KY 40701-4973
(859) 229-4647
Mailing address
1024 GREENDALE RD UNIT 2103, LEXINGTON, KY 40511-8320
(859) 229-4647
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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