Individual
AVANLEIGH MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
613 S KNIK GOOSE BAY RD STE E, WASILLA, AK 99654-8090
(907) 317-5895
Mailing address
5215 46TH STREET CT W, UNIVERSITY PLACE, WA 98466-6658
(253) 509-4466
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
191274
AK
225200000X
Physical Therapy Assistant
60975822
WA
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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