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Individual

BETHANY A MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
805 E GREGORY AVE, MARION, IL 62959-3325
(618) 922-8898
Mailing address
805 E GREGORY AVE, MARION, IL 62959-3325
(618) 922-8898

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005335
IL
225200000X
Physical Therapy Assistant

Other

Enumeration date
02/28/2019
Last updated
02/28/2019
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