| Joel Montgomery Therapist Pa | |
|
2312 Wilton Dr Wilton Manors FL 33305-1249 | |
| (954) 630-2336 | |
| Not Available |
| Full Name | Joel Montgomery Therapist Pa |
|---|---|
| Speciality | Social Worker |
| Location | 2312 Wilton Dr, Wilton Manors, Florida |
| Authorized Official Name and Position | Joel Montgomery (PRESIDENT) |
| Authorized Official Contact | 9546302336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joel Montgomery Therapist Pa 72 Ne 25th St Wilton Manors FL 33305-1026 Ph: (954) 630-2336 | Joel Montgomery Therapist Pa 2312 Wilton Dr Wilton Manors FL 33305-1249 Ph: (954) 630-2336 |
| NPI Number | 1013415231 |
|---|---|
| Provider Enumeration Date | 01/23/2018 |
| Last Update Date | 01/23/2018 |
| Medicare PECOS PAC ID | 5890031090 |
|---|---|
| Medicare Enrollment ID | O20190109000922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013415231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW14839 (Florida) | Primary |
| Provider Name | Joel Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447762315 PECOS PAC ID: 5698011898 Enrollment ID: I20190204002281 |
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