| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MADISON ELISE MOUNTJOY | 1417530049 | 2021-04-30 |
Madison Elise Mountjoy is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417530049. Registration indicates Madison Elise Mountjoy is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Occupational Therapy Assistant (Occupational Therapy Assistant, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Occupational Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Madison Elise Mountjoy COTA/L |
| Practice Office Address | 177 N HIGHLAND ST MEMPHIS, TN US |
| Practice Office Telephone | 9013254000 |
| Mailing Address | 177 N HIGHLAND ST MEMPHIS, TN 38111 US |
| Business Telephone | 9013254000 |
| Code | Practice | License No State |
|---|---|---|
| 224Z00000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapy Assistant Occupational Therapy Assistant Speech/Occupational/Physical Therapy/Chiropractor Occupational Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 3492
TN |