Individual
GERRIT WAYNE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
3545 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 269-5500
Mailing address
1351 WOODLAWN AVE, MOUNT VERNON, MO 65712-2113
(417) 231-6202
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2023004106
MO
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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