Provider Demographics
NPI:1285528273
Name:MONTGOMERY, ELIZABETH R
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 RACE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1091
Mailing Address - Country:US
Mailing Address - Phone:213-448-0462
Mailing Address - Fax:
Practice Address - Street 1:1008 RACE ST STE 5
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1091
Practice Address - Country:US
Practice Address - Phone:213-448-0462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care