Individual
DR. MELISSA KEETON MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
2525 HORIZON LAKE DR STE 101, MEMPHIS, TN 38133-8119
(877) 882-7822
(901) 384-9936
Mailing address
5393 DIXIE CREEK DR, HERNANDO, MS 38632-6368
(187) 788-2782
(901) 384-9936
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10475
MS
183500000X
Pharmacist
14899
AL
183500000X
Pharmacist
Primary
33539
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10475
BOARD OF PHARMACY
MS
01
—
14899
BOARD OF PHARMACY
AL
01
—
33539
BOARD OF PHARMACY
TN
Enumeration date
05/29/2009
Last updated
05/29/2009
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