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Organization

FACT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICAELYN MONTGOMERY MS CCC-SLP (OWNER/SPEECH-LANGUAGE PATHOLOGIST)
(417) 592-4585
Entity
Organization

Contact information

Practice address
2501 S FLORIDA AVE, JOPLIN, MO 64804-2412
(417) 592-4585
Mailing address
2501 S FLORIDA AVE, JOPLIN, MO 64804-2412
(417) 592-4585

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
10/16/2019
Last updated
10/16/2019
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