Individual
MS. BEVERLY A BORELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5533 W HILLSDALE AVE, SUITE 'A', VISALIA, CA 93291-5138
(559) 733-2478
(559) 733-2470
Mailing address
53585 DOGWOOD DR, PO BOX 1521, NORTH FORK, CA 93643-9720
(559) 877-4191
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT1615
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1615
PTA LICENSE NUMBER
CA
Enumeration date
08/29/2006
Last updated
07/08/2007
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