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Individual

MARY ANN DREZA ALINO FERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, COMT

Contact information

Practice address
63 HOSPITALITY LN STE 3, MINERAL WELLS, WV 26150-6705
(304) 489-8100
(304) 489-8191
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(304) 917-3660
(304) 917-3674

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
000839
WV
225100000X
Physical Therapist
0105003469
VA
225100000X
Physical Therapist
13262-24
WI
225100000X
Physical Therapist
Primary
PT000839
WV
225100000X
Physical Therapist
PT003437
GA

Other

Enumeration date
02/11/2015
Last updated
12/23/2022
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