Montgomery, Amanda

Montgomery, Amanda is an sole proprietor health care provider with primary practice located at 812 Coshocton Ave # 3 , Mount Vernon OH 43050-1947. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Montgomery, Amanda can be contacted via phone (740) 326-1190.

Contact Information

Primary practice address
812 Coshocton Ave # 3 Mount Vernon OH 43050-1947
Phone: (740) 326-1190
Fax: (740) 326-9753
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 6058 Ohio

Profile Details

NPI number 1417236803
LBN Legal business name Montgomery, Amanda
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2011
Last updated Sep 29th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417236803 NPPES
Ohio MEDICAID 0112154
Ohio Other 1417236803
Ohio Other CS1627100107

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