Individual
LISA R MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
640 WRIGHT AVE, BOWLING GREEN, KY 42103-1623
(270) 495-4323
Mailing address
640 WRIGHT AVE, BOWLING GREEN, KY 42103-1623
(270) 495-4323
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KY
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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