Provider Demographics
NPI:1306010822
Name:PANETTIERI, ANN MARIE (PT)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:PANETTIERI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22391 GREENTREE CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5330
Mailing Address - Country:US
Mailing Address - Phone:561-551-5049
Mailing Address - Fax:
Practice Address - Street 1:22391 GREENTREE CIR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5330
Practice Address - Country:US
Practice Address - Phone:561-551-5049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist