Individual
MONEISE TAMAR MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7203 SUPERIOR AVE, CLEVELAND, OH 44103-2845
(216) 336-0217
Mailing address
7203 SUPERIOR AVE, CLEVELAND, OH 44103-2845
(216) 336-0217
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RR198149
OH
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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