| Doctor Name: | NATHAN MONTGOMERY |
| NPI Number: | 1366690265 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | SL008853 |
| Business Practice Address: | 1025 Medical Center Dr Suite 201 Wilmington, NC - 284017354 |
| Business Phone Number: | 9103382773 |
| Business Fax Number: | 9103417911 |
| Mailing Address: | 216 N Channel Haven Dr, WILMINGTON |
| State: | NC |
| Postal Code: | 284093504 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/04/2008 |
| NPI Last Update Date: | 05/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SL008853 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |