Individual
DEWAYNE D MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
1180 WEST AVE, CROSSVILLE, TN 38555-4148
(931) 707-3620
(931) 484-7393
Mailing address
551 FOREST DR, CROSSVILLE, TN 38555-8842
(931) 788-3499
(931) 484-7393
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3944
TN
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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