Doctor Name: | JASON MATTHEW MONTOUR |
NPI Number: | 1255578944 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 35318 |
Business Practice Address: | 5 Bon Air Rd Suite 129 Larkspur, CA - 949391143 |
Business Phone Number: | 4159248900 |
Business Fax Number: | 4159247149 |
Mailing Address: | 5 Bon Air Rd, Suite 129 LARKSPUR |
State: | CA |
Postal Code: | 949391143 |
Phone Number: | 4159248900 |
Fax Number: | 4159247149 |
NPI Enumeration Date: | 01/16/2009 |
NPI Last Update Date: | 01/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 35318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |