Provider Demographics
NPI:1467500991
Name:PUTZKA PERRIN, ANNETTE DENISE (PT)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:DENISE
Last Name:PUTZKA PERRIN
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 1:5 HARRIS CT
Mailing Address - Street 2:BUILDING T, SUITE 102
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5750
Mailing Address - Country:US
Mailing Address - Phone:831-372-3579
Mailing Address - Fax:831-372-3779
Practice Address - Street 1:5 HARRIS CT
Practice Address - Street 2:BUILDING T, SUITE 102
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5750
Practice Address - Country:US
Practice Address - Phone:831-372-3579
Practice Address - Fax:831-372-3779
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist