Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 37124 | CA |
NPI | 1326516824 |
---|---|
Provider Name | Bridget Ann Demattio |
First Address | Redding, CA 96001-6312 |
Second Address | Redding, CA 96001-6312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2018 |
Last Update Date | 02/11/2018 |