Most Relevant Information
Provider Data
| NPI Number: | 1003023565 |
| Provider Name: | LEO A MONTAMBEAULT PHARM D |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PS39669 |
Most Important Dates
| Enumeration Date: | 05/16/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1839 58TH ST S
GULFPORT
FL
337074154
Practice Location Phone/Fax
| Phone: | 6032798779 |
| Fax: |
Provider Mailing Location
PO BOX 6642
LACONIA
NH
032476642
Provider Mailing Phone/Fax
| Phone: | 6032798779 |
| Fax: |