Individual
MRS. NICOLE CATHERINE LANNUTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2420 S OPAL ST, PHILADELPHIA, PA 19145-4216
(267) 246-3252
Mailing address
2420 S OPAL ST, PHILADELPHIA, PA 19145-4216
(267) 246-3252
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI000378
PA
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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