Individual
DESIREE MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3066 SR 160, GALLIPOLIS, OH 45631-8409
(740) 446-7459
Mailing address
266 JASON RD, CROWN CITY, OH 45623-8961
(740) 794-0708
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03439580
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03439580
OHIO BOARD OF PHARMACY
OH
Enumeration date
04/26/2021
Last updated
04/26/2021
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