(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003294760
Provider Name: MARTHA MONTGOMERY
Entity Type: Individual
Taxonomy Code: 261QA0600X
Specialty: Clinic/Center
License Number: 261QA0600X
Most Important Dates
Enumeration Date: 05/14/2015
Last Updated: 05/14/2015
Provider Practice Location
112 W FARIS RD
GREENVILLE
SC
296053061
Practice Location Phone/Fax
Phone: 4042900296
Fax:
Provider Mailing Location
112 W FARIS RD
GREENVILLE
SC
296053061
Provider Mailing Phone/Fax
Phone: 4042900296
Fax: