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General NPI Number Information
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NPI Number | 1770853566
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Entity Type | Individual
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Provider Name | AUBREY TENNANT DPT
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Gender | Female
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 1650 LEAD HILL BLVD
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City | ROSEVILLE
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State | CA
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Zip | 95661-3061
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Country | US
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Telephone | 916-677-1210
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Fax | 916-344-1214
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Provider Business Mailing Address
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Address Line | 3068 RIDGEVIEW DR
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-4342
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Country | US
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Telephone | 916-832-0911
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Fax | 916-677-1214
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 38594
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License Number State | CA
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