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General NPI Number Information
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NPI Number | 1932144961
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Entity Type | Individual
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Provider Name | MONTY HARRISON MONTGOMERY DNM, PHD, ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 621 E 53RD ST S
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City | MUSKOGEE
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State | OK
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Zip | 74403-8566
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Country | US
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Telephone | 918-680-0767
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Fax | 918-683-4118
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Provider Business Mailing Address
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Address Line | 621 E 53RD ST S
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City | MUSKOGEE
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State | OK
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Zip | 74403-8566
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Country | US
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Telephone | 918-680-0767
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Fax | 918-683-4118
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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