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Individual

MR. RON BLAKE MONTGOMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNIM

Contact information

Practice address
134 HAWKINS RD, ARMUCHEE, GA 30105-2069
(706) 506-9877
(972) 349-1249
Mailing address
134 HAWKINS RD, ARMUCHEE, GA 30105-2069
(706) 506-9877
(972) 349-1249

Taxonomy

Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
2728
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2278
CNIM
GA
Enumeration date
02/04/2015
Last updated
02/04/2015
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