Organization
NATIONAL ATHLETIC ALLIANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA M VENTRICELLI (ADMINISTRATOR)
(928) 636-9053
Entity
Organization
Contact information
Practice address
410 MOREHOUSE RD, EASTON, CT 06612-1638
(928) 636-9053
Mailing address
21320 N TWO HAWK RD, PAULDEN, AZ 86334-4329
(928) 636-9053
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
005593
CT
Other
Enumeration date
11/03/2005
Last updated
08/02/2008
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