Doctor Name: | MR. BRADLEY SCOTT MONTGOMERY |
NPI Number: | 1457376824 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC |
License Number: | 068 |
Business Practice Address: | Uwa Station 14 Livingston, AL - 354700682 |
Business Phone Number: | 2056523696 |
Business Fax Number: | 2056523799 |
Mailing Address: | Uwa Station 14, LIVINGSTON |
State: | AL |
Postal Code: | 354700682 |
Phone Number: | 2056523696 |
Fax Number: | 2056523799 |
NPI Enumeration Date: | 07/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 068 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |