Provider Demographics
NPI:1407929888
Name:MONTGOMERY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:MONTGOMERY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-333-0798
Mailing Address - Street 1:7 SOUTHERN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-2355
Mailing Address - Country:US
Mailing Address - Phone:609-333-0798
Mailing Address - Fax:
Practice Address - Street 1:382 ROUTE 518
Practice Address - Street 2:SUITE A
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2211
Practice Address - Country:US
Practice Address - Phone:609-933-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00548000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy