Individual
MR. WILLIAM CHAD MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
208 SIMMONS CREEK DR, PONTOTOC, MS 38863-2110
(662) 419-8344
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3892
MS
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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