Organization
CLEARWAY SURGERY CENTER OF CRESTVIEW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KACEY A MONTGOMERY M.D. (REGIONAL MEDICAL DIRECTOR)
(850) 791-6895
Entity
Organization
Contact information
Practice address
180A E REDSTONE AVE, CRESTVIEW, FL 32539-5348
(850) 484-4080
(850) 484-8801
Mailing address
201 DEFENSE HWY STE 205, ANNAPOLIS, MD 21401-7096
(855) 527-7246
(833) 810-1165
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
05/17/2022
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