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Individual

MRS. ANNA MARIE BAUTISTA AVELLANOSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
525 BRANSON LANDING BLVD., BRANSON, MO 65616
(417) 348-8212
(417) 348-8218
Mailing address
109 BRIARCLIFF RD, BRANSON, MO 65616-3735
(417) 339-4069

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT111250
MO

Other

Enumeration date
11/10/2014
Last updated
11/10/2014
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