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Individual

ANITA M TERRANOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
13430 NW QUARTERHORSE WAY, BREMERTON, WA 98312-3524
(360) 865-2654
Mailing address
13430 NW QUARTERHORSE WAY, BREMERTON, WA 98312-3524

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P161035801
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P161035801
STATE LICENSE
WA
Enumeration date
09/09/2020
Last updated
09/23/2021
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