Provider Demographics
NPI:1083184287
Name:MONTGOMERY, NATALIE (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:HORVAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 MELVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-3541
Mailing Address - Country:US
Mailing Address - Phone:330-316-8849
Mailing Address - Fax:
Practice Address - Street 1:109 MELVILLE RD
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-3541
Practice Address - Country:US
Practice Address - Phone:330-316-8849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011635225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist