Individual
KEVIN M MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
946 GOSS AVE APT 5101, LOUISVILLE, KY 40217-2284
(270) 577-7045
Mailing address
946 GOSS AVE APT 5101, LOUISVILLE, KY 40217-2284
(270) 577-7045
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
167765
KY
225X00000X
Occupational Therapist
31005502A
IN
Other
Enumeration date
07/10/2013
Last updated
03/17/2018
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