Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2566 | AK |
N | 2251N0400X | Physical Therapist - Neurology | 2566 | AK |
Y | 2251P0200X | Physical Therapist - Pediatrics | 2566 | AK |
N | 2251X0800X | Physical Therapist - Orthopedic | 2566 | AK |
NPI | 1114269198 |
---|---|
Provider Name | Sara Montgomery |
First Address | Anchorage, AK 99518-2283 |
Second Address | Anchorage, AK 99518-2283 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2013 |
Last Update Date | 13/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1583208 | (05) | AK |