Individual
ALENA BOLSHAKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3120 SUN DRENCHED PATH, AUSTIN, TX 78732-1950
(404) 493-1628
Mailing address
3120 SUN DRENCHED PATH, AUSTIN, TX 78732-1950
(404) 493-1628
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2157760
TX
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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