Individual
JESSE ROBERTSON MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-7000
Mailing address
5 E 5900 S, MURRAY, UT 84107-7254
(801) 473-9369
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9852709-4202
UT
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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