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PAUL M MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
2504 S CHICAGO ST, FAIRCHILD AFB, WA 99011-8548
(509) 247-5414
Mailing address
274 N WATSON RD, CALEDONIA, MS 39740-9573
(662) 435-0279

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
07/20/2009
Last updated
07/20/2009
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