Provider Demographics
NPI:1477752251
Name:MONTAGUE, ELIZABETH CLAIRE (PT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:MONTAGUE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:212 WAX MYRTLE CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5133
Mailing Address - Country:US
Mailing Address - Phone:919-460-7858
Mailing Address - Fax:919-460-7858
Practice Address - Street 1:110 CORNING RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9235
Practice Address - Country:US
Practice Address - Phone:919-858-1645
Practice Address - Fax:919-858-1625
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist