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General NPI Number Information
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NPI Number | 1831821826
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Entity Type | Individual
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Provider Name | TREVOR KEITH MONTGOMERY PT
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Gender | Male
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 724 W MAIN ST
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City | LEWISVILLE
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State | TX
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Zip | 75067-3514
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Country | US
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Telephone | 940-270-8485
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Fax |
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Provider Business Mailing Address
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Address Line | 113 WOODED ACRE LOOP
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City | WHITNEY
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State | TX
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Zip | 76692-4806
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Country | US
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Telephone | 254-479-6929
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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