Individual
ANNIE KANNENPLA VERGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(916) 734-7248
Mailing address
233 BRIGGS RANCH DR, FOLSOM, CA 95630-5269
(626) 807-7906
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18310
CA
Other
Enumeration date
08/31/2007
Last updated
08/31/2007
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