Individual
FANSHON MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 ALBION ST, NASHVILLE, TN 37208-2918
(615) 341-4000
Mailing address
814 JOLIET DR, CAHOKIA, IL 62206-2054
(601) 983-0032
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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