Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
Y | 225100000X | Physical Therapist | 30117 | AZ |
N | 2251E1200X | Ergonomics | 30117 | AZ |
N | 225XE1200X | Ergonomics | 30117 | AZ |
N | 2251N0400X | Physical Therapist - Neurology | 30117 | AZ |
N | 2251S0007X | Physical Therapist - Sports | 30117 | AZ |
N | 2251X0800X | Physical Therapist - Orthopedic | 30117 | AZ |
NPI | 1639637614 |
---|---|
Provider Name | Dr. Johnathan Scott Monteiro |
First Address | Phoenix, AZ 85012-2105 |
Second Address | Phoenix, AZ 85012-2105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2019 |
Last Update Date | 25/06/2021 |