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Organization
GARY COLLETTO PT
Active
Organization
GARY COLLETTO PT
Active
Other names
Colletto Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE PRENTICE PT (PT)
(818) 366-3935
Entity
Organization
Contact information
Practice address
10605 BALBOA BLVD, #240, GRANADA HILLS, CA 91344-6342
(818) 366-3935
(818) 368-9351
Mailing address
16692 KNOLLWOOD DR, GRANADA HILLS, CA 91344-2621
(818) 366-3935
(818) 368-9351
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7597
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
698117
ACN GROUP UHC
CA
Enumeration date
03/29/2007
Last updated
08/22/2020
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