Individual
MS. ALTHEA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10459 TARA BEACH CIR, JONESBORO, GA 30238-7955
(678) 230-7272
(770) 478-5214
Mailing address
10459 TARA BEACH CIR, JONESBORO, GA 30238-7955
(678) 230-7272
(770) 478-5214
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056-005430
IL
225X00000X
Occupational Therapist
1586
AL
225X00000X
Occupational Therapist
OT0007107
FL
225XP0200X
Pediatric Occupational Therapist
056-005430
IL
225XP0200X
Pediatric Occupational Therapist
Primary
2534
GA
226300000X
Kinesiotherapist
1263
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000902195A
—
GA
Enumeration date
09/13/2005
Last updated
08/14/2007
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