Individual
MRS. KACIE BRAGG MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
831 MCDOW DR, ROCK HILL, SC 29732-2415
(803) 326-3115
Mailing address
1715 MADISON ST, ROCK HILL, SC 29732-1628
(803) 329-3524
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2754
SC
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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