Individual
BETHANEE VERIANNA VASSANTACHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1189 W STATE ST, REDLANDS, CA 92373-8123
(909) 307-9121
(909) 307-9161
Mailing address
1189 W STATE ST, REDLANDS, CA 92373-8123
(909) 307-9121
(909) 307-9161
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
36035
CA
Other
Enumeration date
12/22/2009
Last updated
05/15/2014
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