| Montgomery Group, Llc | |
|
4108 Park Rd Ste 411 Charlotte NC 28209-2262 | |
| (980) 949-8990 | |
| Not Available |
| Full Name | Montgomery Group, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4108 Park Rd Ste 411, Charlotte, North Carolina |
| Authorized Official Name and Position | John A Burns (PARTNER) |
| Authorized Official Contact | 7046223450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Group, Llc 4108 Park Rd Ste 411 Charlotte NC 28209-2262 Ph: (980) 949-8990 | Montgomery Group, Llc 4108 Park Rd Ste 411 Charlotte NC 28209-2262 Ph: (980) 949-8990 |
| NPI Number | 1629540208 |
|---|---|
| Provider Enumeration Date | 12/20/2018 |
| Last Update Date | 09/09/2019 |
| Medicare PECOS PAC ID | 4183965023 |
|---|---|
| Medicare Enrollment ID | O20190403000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629540208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | John Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881900447 PECOS PAC ID: 0143560920 Enrollment ID: I20190313001972 |
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