Individual
JODY L MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
76 PORTNER ST, PLYMOUTH, OH 44865-1221
(419) 687-0564
Mailing address
76 PORTNER ST, PLYMOUTH, OH 44865-1221
(419) 687-0564
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
379288570900
OH
Other
Enumeration date
04/29/2010
Last updated
04/29/2010
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