Organization
FOUR RIVERS VISION THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CANAAN MATTHEW MONTGOMERY OD (OWNER)
(270) 558-4741
Entity
Organization
Contact information
Practice address
4570 PECAN DR, SUITE C, PADUCAH, KY 42001-6717
(270) 558-4741
(270) 558-4742
Mailing address
4570 PECAN DR, SUITE C, PADUCAH, KY 42001-6717
(270) 558-4741
(270) 558-4742
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1958DT
KY
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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