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General NPI Number Information
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NPI Number | 1003316977
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH MONTGOMERY PT
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Gender | Female
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Dates
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Enumeration Date | 02/17/2018
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Last Update Date | 02/17/2018
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Provider Practice Location Address
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Address Line | 364 LONGS POND RD STE H
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City | LEXINGTON
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State | SC
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Zip | 29073-7942
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Country | US
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Telephone | 803-358-9400
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Fax | 803-358-9898
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Provider Business Mailing Address
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Address Line | PO BOX 1590
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City | LEXINGTON
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State | SC
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Zip | 29071-1590
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Country | US
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Telephone | 803-358-9400
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Fax | 803-358-9898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8951
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License Number State | SC
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