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Individual

CHARITY FERTITTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
7733 UPTON OXMOOR LN APT 209, LOUISVILLE, KY 40222-3435
(225) 485-2277

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A04242
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225200000X
KY
Enumeration date
09/13/2021
Last updated
09/13/2021
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