Individual
LAURA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
101 N. MAIN ST, PROSPERITY, SC 29127
(803) 364-2310
(803) 364-2311
Mailing address
PO BOX 147, PROSPERITY, SC 29127-0147
(803) 364-2310
(803) 364-2311
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12640
SC
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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