Individual
ELIZABETH ANNE GRETHER-WYSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
707 LINCOLN CTR, STOCKTON, CA 95207-2644
(209) 478-3900
(209) 478-3979
Mailing address
3731 HORTON LN, CARMICHAEL, CA 95608-2322
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9330
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT 9330
PTA LICENSE
CA
Enumeration date
10/07/2010
Last updated
10/07/2010
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