Provider Demographics
NPI:1063679132
Name:MONTGOMERY, JAMES D (CMT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:MONTGOMERY
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5153 W 120TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5608
Mailing Address - Country:US
Mailing Address - Phone:720-327-6529
Mailing Address - Fax:303-404-0948
Practice Address - Street 1:5153 W 120TH AVE
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-5608
Practice Address - Country:US
Practice Address - Phone:720-327-6529
Practice Address - Fax:303-404-0948
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist