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General NPI Number Information
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NPI Number | 1457571002
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Entity Type | Individual
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Provider Name | MRS. JENNIFER L MONTROSS
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | RR 4 BOX 646 ENCORE THERAPY SERVICES INC
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City | W PITTSTON
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State | PA
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Zip | 18643
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Country | US
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Telephone | 570-388-4094
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Fax | 570-388-2104
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Provider Business Mailing Address
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Address Line | RR 4 BOX 646
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City | W PITTSTON
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State | PA
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Zip | 18643
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Country | US
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Telephone | 570-388-4094
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Fax | 570-388-2104
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC005459L
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License Number State |
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