Individual
MS. LAURA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
515 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-2211
(254) 965-3611
(254) 965-3618
Mailing address
295 COUNTY ROAD 443, STEPHENVILLE, TX 76401-7226
(254) 968-2990
(254) 965-3611
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089211903
—
TX
05
—
089211906
—
TX
01
—
8T5520
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/26/2006
Last updated
05/26/2010
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