Individual
CHERI M. VAN ATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
4140 BERRYHILL RD, PACE, FL 32571-8313
(850) 995-7042
Mailing address
3950 HARBORS PORT ST, PACE, FL 32571-6312
(850) 206-6817
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA32117
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2955
BCBS PROVIDER #
FL
Enumeration date
01/08/2007
Last updated
07/08/2007
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