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General NPI Number Information
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NPI Number | 1558787754
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Entity Type | Individual
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Provider Name | ANTHONY ANDREW PIEMONTESE JR. PTA
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Gender | Male
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 294 25TH ST SE
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City | VERO BEACH
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State | FL
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Zip | 32962-8232
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Country | US
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Telephone | 772-475-3721
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Fax |
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Provider Business Mailing Address
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Address Line | 20237 SILKTASSEL RD
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City | RIVERSIDE
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State | CA
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Zip | 92508-3025
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Country | US
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Telephone | 772-475-3721
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | AT10217
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA22843
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License Number State | FL
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