Organization
PREMIER HEALTHCARE PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN ELAINE MONTGOMERY NP (NP)
(404) 314-7295
Entity
Organization
Contact information
Practice address
3962 BUSBY MILL CT, ELLENWOOD, GA 30294-2052
(404) 314-7295
Mailing address
3962 BUSBY MILL CT, ELLENWOOD, GA 30294-2052
(404) 314-7295
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/24/2020
Last updated
02/24/2020
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