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MR. BRADLEY SCOTT MONTGOMERY ATC

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1457376824

Individual Registrant:
MR. BRADLEY SCOTT MONTGOMERY ATC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
UWA STATION 14  LIVINGSTON, AL 35470-0682 US
Tel: 205-652-3696  Fax: 205-652-3799

Contact information for business:
UWA STATION 14  LIVINGSTON, AL 35470-0682 US
Tel: 205-652-3696  Fax: 205-652-3799

Registration Information:
NPI: 1457376824
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y390200000XStudent
Organized Health Care Education/Training Program
AL068

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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