Individual
SUSAN L MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5109 WORLD DAIRY DR, MADISON, WI 53718-3807
(608) 242-0220
(608) 242-1166
Mailing address
5109 WORLD DAIRY DR, MADISON, WI 53718-3807
(608) 242-0220
(608) 242-1166
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318435-31
WI
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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