Individual
DYLAN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
38004 WACO RD, SHAWNEE, OK 74801-8720
(580) 229-3479
Mailing address
38004 WACO RD, SHAWNEE, OK 74801-8720
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
—
—
Other
Enumeration date
02/13/2022
Last updated
02/13/2022
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