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Individual
VELLA R BRANSTETTER
Active
Individual
VELLA R BRANSTETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007156A
IN
225100000X
Physical Therapist
070-013109
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000790487
ANTHEM PROVIDER NUMBER
IN
05
—
200319360
—
IN
Enumeration date
09/14/2006
Last updated
06/25/2013
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