Individual
KELLY MONTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1731 17TH AVE, BLOOMER, WI 54724-1512
(715) 568-4669
(715) 568-4673
Mailing address
1731 17TH AVE, BLOOMER, WI 54724-1512
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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