Individual
MRS. ANITA MARIA THREAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
100 WHITLOCK AVE NW, MARIETTA, GA 30064-2362
(770) 691-1903
Mailing address
8547 W APPLETON AVE, MILWAUKEE, WI 53225-4226
(414) 698-7823
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004656
GA
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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