Individual
MICHAEL VANNATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2524
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497982797
—
ID
05
—
1497982797-000
—
ID
05
—
1497982797-001
—
ID
05
—
1497982797-002
—
ID
01
—
P0080244
RR MEDICARE
ID
Enumeration date
06/15/2009
Last updated
01/27/2012
Update your record
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