Mikayla Montgomery, LPTA
Individual provider Active NPI Physical Therapy Assistant · Independence, VA
NPI 1194241307 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1194241307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2306604796 (VA)
- Practice address
- 574 E Main St
Independence, VA 24348-3879 - Phone
- (276) 773-8118
- NPI assigned
- Aug 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2306604796 | VA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Worrell Therapy Services LLC | Current |
Accepting new patients |
Locations
574 E Main St
Independence, VA 24348
Phone (276) 733-6287
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306604796 | VA | Yes |
Addresses
Primary practice location
574 E Main St
Independence, VA 24348-3879
Mailing address
574 E Main St
Independence, VA 24348-3879
Phone (276) 773-8118
Other providers in Independence, VA
- Scarlett Michelle Love
- Jessica McArthur
- Kristi McCormick
- Patsy O McKnight
- Gordon Joseph Miniclier
- New River Home Health Care LLC
- New River Home Health Services, LLC.
- Ryan Nielson
- Brandy S Ring
- Mary Alice Royal
All providers in Independence, VA · Physical Therapy Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.