Provider Demographics
NPI:1609017201
Name:MONTGOMERY, SARAH K (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:K
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 E BIDWELL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3565
Mailing Address - Country:US
Mailing Address - Phone:916-983-5915
Mailing Address - Fax:916-983-5925
Practice Address - Street 1:1301 E BIDWELL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3565
Practice Address - Country:US
Practice Address - Phone:916-983-5900
Practice Address - Fax:916-983-5913
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35488225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist