Individual
ZACK ALLEN MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BLVD RM 127, DETROIT, MI 48202-2608
(313) 916-3056
Mailing address
110 STEPHENS RD, GROSSE POINTE FARMS, MI 48236-3625
(313) 720-0692
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4351050165
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/28/2021
Last updated
06/15/2022
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