Individual
ANTHONY CARRATELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
54210 MARIAN VIEW DR., IDYLLWILD, CA 92549-0708
(951) 236-6628
Mailing address
PO BOX 708, IDYLLWILD, CA 92549-0708
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT291944
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96807121G86277
—
CA
Enumeration date
12/28/2016
Last updated
12/28/2016
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