Provider Demographics
NPI:1497875793
Name:MONTROSE, LUKE (PT, MS, FAAOMPT)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:MONTROSE
Suffix:
Gender:M
Credentials:PT, MS, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 BEACON ST STE 6C
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3806
Mailing Address - Country:US
Mailing Address - Phone:617-730-5337
Mailing Address - Fax:617-730-5461
Practice Address - Street 1:1180 BEACON ST STE 6C
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3806
Practice Address - Country:US
Practice Address - Phone:617-730-5337
Practice Address - Fax:617-730-5461
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist