Individual
SUSAN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26505
(304) 598-4118
Mailing address
725 MADISON AVE, MORGANTOWN, WV 26501-6721
(304) 296-5881
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
938
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003992
—
WV
Enumeration date
12/01/2006
Last updated
07/08/2007
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