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Individual

KIA DENAE MONTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Mailing address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10213
SC
2251P0200X
Pediatric Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TH5050
SC
Enumeration date
07/15/2020
Last updated
10/14/2022
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