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NPI Code Detail

MEDICARE: KELSEY LYNN MONTGOMERY PT, DPT

MEDICARE: KELSEY LYNN MONTGOMERY PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2021004462MO
2225100000XPhysical Therapist11-06995KS

General Provider Information

NPI Number : 1770232266
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY LYNN MONTGOMERY PT, DPT
Provider Business Mailing Address
First Line : 8477 S SUNCOAST BLVD
Second Line :
City : HOMOSASSA
State : FL
Zip : 34446-5028
Country : US
Telephone Number : 800-381-0822
Fax Number :
Provider Business Practice Location Address
First Line : 13875 W 115TH TER
Second Line :
City : OLATHE
State : KS
Zip : 66062-7937
Country : US
Telephone Number : 800-381-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2022
Last Update Date : 06/08/2026

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