Individual
DR. ANDRE LAMONT MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
684 AVON BELDEN RD, SUITE B, AVON LAKE, OH 44012-4110
(440) 930-5537
(440) 930-5237
Mailing address
684 AVON BELDEN ROAD, SUITE B, AVON LAKE, OH 44012-4111
(440) 930-5537
(440) 930-5237
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3302
OH
111NS0005X
Sports Physician Chiropractor
3302
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2324167
—
OH
Enumeration date
04/17/2006
Last updated
12/08/2020
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