Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 2007-19 | WI |
Y | 225200000X | Physical Therapy Assistant | 5502006380 | MI |
N | 225200000X | Physical Therapy Assistant | PTA0000003525 | TN |
NPI | 1013179803 |
---|---|
Provider Name | Mr. William M Vittone |
First Address | Shelby Township, MI 48317-2595 |
Second Address | Ashland, WI 54806-1311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 11/02/2022 |