Individual
RYAN MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11616 N 34TH AVE, OMAHA, NE 68112-1147
(319) 389-4505
Mailing address
11616 N 34TH AVE, OMAHA, NE 68112-1147
(319) 389-4505
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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