Provider Demographics
NPI:1255207213
Name:MONTGOMERY PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:MONTGOMERY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THORELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MS,CSCS
Authorized Official - Phone:936-597-5323
Mailing Address - Street 1:20873 EVA ST STE C
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-1975
Mailing Address - Country:US
Mailing Address - Phone:936-597-5323
Mailing Address - Fax:936-597-8914
Practice Address - Street 1:20873 EVA ST STE C
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-1975
Practice Address - Country:US
Practice Address - Phone:936-597-5323
Practice Address - Fax:936-597-8914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty