Provider Demographics
NPI:1922111301
Name:MONTGOMERY, JOYCE A (PT)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
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 1:9070 ROCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7237
Mailing Address - Country:US
Mailing Address - Phone:719-282-3172
Mailing Address - Fax:719-282-1865
Practice Address - Street 1:9070 ROCHESTER DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7237
Practice Address - Country:US
Practice Address - Phone:719-282-3172
Practice Address - Fax:719-282-1865
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist