Individual
MISS KACI MARI MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1208 PINE RIDGE DAIRY RD, FRUITLAND PARK, FL 34731-3412
(352) 223-6903
Mailing address
1208 PINE RIDGE DAIRY RD, FRUITLAND PARK, FL 34731-3412
(352) 223-6903
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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