Provider Demographics
NPI:1184784365
Name:CASSADY, CARI ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:CARI
Middle Name:ANN
Last Name:CASSADY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CARI
Other - Middle Name:ANN
Other - Last Name:MESSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-0069
Mailing Address - Country:US
Mailing Address - Phone:209-742-7272
Mailing Address - Fax:209-742-7368
Practice Address - Street 1:5072 BULLION STREET
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338
Practice Address - Country:US
Practice Address - Phone:209-742-7272
Practice Address - Fax:209-742-7368
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist