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Individual
KATHERYN TAN-ATIENZA
Active
Individual
KATHERYN TAN-ATIENZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017976
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05598827TPA
AMERIHEALTH ADMINISTRATOR
PA
01
—
GEA7038740100
BLUE CROSS PPO
PA
Enumeration date
03/26/2007
Last updated
03/23/2019
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