Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 8511 | CA |
NPI | 1003001546 |
---|---|
Provider Name | Ann-Marie Bragano |
First Address | Rohnert Park, CA 94928-2900 |
Second Address | Rohnert Park, CA 94928-2900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2007 |
Last Update Date | 07/09/2007 |