Aillene Montgomery, LPTA

Individual provider Active NPI Physical Therapy Assistant · Beaver, OH

NPI 1790083152 · NPPES record last updated Mar 9, 2011

Key facts

NPI
1790083152
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1540 (OH)
Practice address
2600 Rapp Montgomery Rd
Beaver, OH 45613-9431
Phone
(740) 835-7902
NPI assigned
Mar 9, 2011
Sex
Female
Sole proprietor
Yes

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
1540OHMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1540 OH Yes

Addresses

Primary practice location

2600 Rapp Montgomery Rd
Beaver, OH 45613-9431

Mailing address

2600 Rapp Montgomery Rd
Beaver, OH 45613-9431
Phone (740) 835-7902

Other providers in Beaver, OH

All providers in Beaver, OH · Physical Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.