Kennisha Montgomery

NPI #1205320504 in Azusa, California

Provider Information

NPI Number: 1205320504
Entity Type: Individual
Name: Kennisha Montgomery
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jun 20, 2018
Last Updated: Jun 20, 2018

Practice Location

Address: 901 E ALOSTA AVE
City: Azusa
State: California
ZIP Code: 91702-2701
Phone: (626) 815-6000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X

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