Individual
ANDREA LYNN MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1551 WALL ST, SAINT CHARLES, MO 63303-3539
(636) 947-1666
Mailing address
15 APEX DR, HIGHLAND, IL 62249-1282
(618) 651-0444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2007004518
MO
Other
Enumeration date
05/12/2010
Last updated
07/24/2018
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