Diane Beth Montgomery, PT

Individual provider Active NPI Physical Therapist · Rushford, MN

NPI 1023356557 · NPPES record last updated Jan 17, 2013

Key facts

NPI
1023356557
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501 (MN)
Practice address
109 W Jessie St
Rushford, MN 55971-8837
Phone
(507) 864-7726
NPI assigned
Jan 17, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
070.004651ILMDPhysical Therapist
5501MNMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501 MN Yes
Physical Therapist 225100000X 070.004651 IL

Addresses

Primary practice location

109 W Jessie St
Rushford, MN 55971-8837

Mailing address

420 E Sarnia St
Winona, MN 55987-6365
Phone (507) 457-4329

Other providers in Rushford, MN

All providers in Rushford, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.