Individual
JASON MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6549 TOWN CENTER DR, CLARKSTON, MI 48346-4824
(248) 620-6400
Mailing address
6549 TOWN CENTER DR, CLARKSTON, MI 48346-4824
(248) 620-6400
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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