MEDICARE: COUNTY OF MONTGOMERY SCHOOL DIST

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700927456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF MONTGOMERY SCHOOL DIST

Provider Business Mailing Address
First Line	:	418 N HIGHWAY 19
Second Line	:
City	:	MONTGOMERY CITY
State	:	MO
Zip	:	63361-5217
Country	:	US
Telephone Number	:	573-564-3710
Fax Number	:	573-564-6182

Provider Business Practice Location Address
First Line	:	418 N HIGHWAY 19
Second Line	:
City	:	MONTGOMERY CITY
State	:	MO
Zip	:	63361-5217
Country	:	US
Telephone Number	:	573-564-3710
Fax Number	:	573-564-6182

Authorized Official
Title or Position	:	DISTRICT COORDINATOR
Name	:	LORI MILLAM
Credential	:
Telephone Number	:	573-564-3710

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	06/14/2016

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Directions to “COUNTY OF MONTGOMERY SCHOOL DIST ” Practice Location

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