Individual
ADAM THOMAS MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
15487 WILD CHERRY LN, EMINENCE, MO 65588-9137
(573) 351-9660
Mailing address
15487 WILD CHERRY LN, EMINENCE, MO 65588-9137
(573) 351-9660
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2022046153
MO
225X00000X
Occupational Therapist
Primary
2026003979
MO
Other
Enumeration date
05/29/2025
Last updated
01/28/2026
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