Provider Demographics
NPI:1295086387
Name:MINASOLA, MICHELE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MINASOLA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:BLATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:5532 W PEREZ AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8885
Mailing Address - Country:US
Mailing Address - Phone:559-909-4197
Mailing Address - Fax:559-553-0833
Practice Address - Street 1:5532 W PEREZ AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-8885
Practice Address - Country:US
Practice Address - Phone:559-909-4197
Practice Address - Fax:559-909-4197
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33994225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic