Provider Demographics
NPI:1700171832
Name:MONTFAIR MEDICAL STAFFING
Entity Type:Organization
Organization Name:MONTFAIR MEDICAL STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTORFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-419-6689
Mailing Address - Street 1:31 HARMONY HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3692
Mailing Address - Country:US
Mailing Address - Phone:832-419-6689
Mailing Address - Fax:
Practice Address - Street 1:31 HARMONY HOLLOW CT
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77385-3692
Practice Address - Country:US
Practice Address - Phone:832-419-6689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty