Individual
BRIANNA NICOLE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6200 PFEIFFER RD, MONTGOMERY, OH 45242-5862
(513) 985-0900
Mailing address
4201 VICTORY PKWY APT 712, CINCINNATI, OH 45229-1672
(513) 377-6728
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.023423
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102154285-00
CARE SOURCE
OH
Enumeration date
06/01/2019
Last updated
06/01/2019
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