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1710505649
LACRISTA MONTGOMERY
TUPELO, MS
NPI
1710505649
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1744P3200X Specialist, Prosthetics Case Management
(Licence: MS 0059659)
Enumeration Date
2020-07-07
Last Update Date
2020-07-07
Business Address
LACRISTA MONTGOMERY Specialust
811 GARFIELD ST
TUPELO, MS 38801-5748
Phone number: 662-422-6044
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Mailing Address
LACRISTA MONTGOMERY Specialust
142 WOODGREEN RD APT 23
PLANTERSVILLE, MS 38862-9709
Phone number:
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