Provider Demographics
NPI:1639384654
Name:MONTALBANO, JANICE HUESCA (PT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:HUESCA
Last Name:MONTALBANO
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 1:1926 ROBINWOOD RD APT I
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1642
Mailing Address - Country:US
Mailing Address - Phone:704-685-0017
Mailing Address - Fax:
Practice Address - Street 1:1926 ROBINWOOD RD APT I
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1642
Practice Address - Country:US
Practice Address - Phone:704-685-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist