Individual
MRS. HEIDI ANN ANTICEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5704 DAMON ST, SIMI VALLEY, CA 93063-4229
(805) 526-9532
Mailing address
5704 DAMON ST, SIMI VALLEY, CA 93063-4229
(805) 526-9532
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT4620
CA
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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