Provider Demographics
NPI:1376749457
Name:ANASTASI, ELIZABETH MARY (CMT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARY
Last Name:ANASTASI
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:MARY
Other - Last Name:KNOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMT
Mailing Address - Street 1:630 SALEM ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928
Mailing Address - Country:US
Mailing Address - Phone:530-345-9725
Mailing Address - Fax:
Practice Address - Street 1:630 SALEM ST
Practice Address - Street 2:SUITE 220
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-345-9725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist