Organization
MONTGOMERY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY I LONG MD (OFFICER)
(318) 354-9348
Entity
Organization
Contact information
Practice address
641 ROWENA ST, MONTGOMERY, LA 71454
(318) 354-9348
Mailing address
114 E 5TH ST, NATCHITOCHES, LA 71457-5725
(318) 354-9348
(318) 354-9269
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022285
LA
Other
Enumeration date
03/18/2009
Last updated
03/18/2009
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