Individual
AEASTLY MONTILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
926 MAIN ST, NASHVILLE, TN 37206-3614
(615) 679-9087
Mailing address
926 MAIN ST, NASHVILLE, TN 37206-3614
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
10054
MA
225200000X
Physical Therapy Assistant
Primary
PTA28218
FL
Other
Enumeration date
08/23/2022
Last updated
08/21/2023
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