Provider Demographics
NPI:1639637614
Name:MONTEIRO, JOHNATHAN SCOTT (DPT)
Entity type:Individual
Prefix:DR
First Name:JOHNATHAN
Middle Name:SCOTT
Last Name:MONTEIRO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 E JACKSON ST STE 600
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-2254
Mailing Address - Country:US
Mailing Address - Phone:480-886-2253
Mailing Address - Fax:480-790-4350
Practice Address - Street 1:926 E JACKSON ST STE 600
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-2254
Practice Address - Country:US
Practice Address - Phone:480-886-2253
Practice Address - Fax:480-790-4350
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
AZ30117225100000X, 2251E1200X, 2251N0400X, 2251X0800X, 2251S0007X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports