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Individual
JOANNE INGRAM
Active
Individual
JOANNE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT13147
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219113
STATE OF WA
WA
01
—
0PT131472
MEDICARE PTAN
CA
Enumeration date
12/22/2005
Last updated
01/07/2008
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