Michael Montgomery Od PC

NPI #1316078868 in Lebanon, Missouri

Provider Information

NPI Number: 1316078868
Entity Type: Organization
Organization Name: Michael Montgomery Od PC
Primary Specialty: Ophthalmology
Enumeration Date: Mar 8, 2007
Last Updated: Mar 14, 2011

Practice Location

Address: 279 E ELM
City: Lebanon
State: Missouri
ZIP Code: 65536
Phone: (417) 532-2562

Authorized Official

Name: DR. MICHAEL R MONTGOMERY, O.D., P.C.
Title: DOCTOR OF OPTOMETRY
Phone: (417) 532-2562

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Eyewear Supplier	332H00000X
Ophthalmology	207W00000X	Primary

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