Organization
GULF COAST PAIN CONSULTANTS LLC
Active
Other names
Clearway Pain Solutions Institute
Organization subpart
No
Provider details
NPI number
Authorized official
KACEY MONTGOMERY MD (MEDICAL DIRECTOR)
(850) 791-6895
Entity
Organization
Contact information
Practice address
182 A EAST REDSTONE AVE, CRESTVIEW, FL 32539-5371
(850) 484-4080
(850) 484-8801
Mailing address
201 DEFENSE HWY STE 205, ANNAPOLIS, MD 21401-7096
(855) 527-7246
(833) 810-1165
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
01/31/2023
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