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Individual

DR. RONALD DALE MONTGOMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
6846 COOLEY LAKE ROAD, WATERFORD, MI 48327-4109
(248) 363-1543
Mailing address
6846 COOLEY LAKE ROAD, WATERFORD, MI 48327-4109
(248) 363-1543

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005148
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1754078
MI
01
950F35099
BLUE CROSS
MI
Enumeration date
08/31/2006
Last updated
07/15/2010
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