Antara Pommells Croft, PTA
Individual provider Active NPI Physical Therapy Assistant · Cheney, WA
NPI 1306255658 · NPPES record last updated Aug 11, 2014
Key facts
- NPI
- 1306255658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- P1 60471534 (WA)
- Practice address
- 2219 N 6TH St
Cheney, WA 99004-2171 - Phone
- (509) 235-6196
- NPI assigned
- Aug 11, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1 60471534 | WA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | P1 60471534 | WA | Yes |
Addresses
Primary practice location
2219 N 6TH St
Cheney, WA 99004-2171
Mailing address
2219 N 6TH St
Cheney, WA 99004-2171
Phone (509) 235-6196
Other providers in Cheney, WA
- Mariana Coronel
- Sarah Brielle Cortez
- Kodie Marie Counsell
- Dionna Cox
- Kristin Cox
- Margaret Jean Dancan
- Jamie Lynn Deandre
- Gregory Dellino
- Sonya Paula Dewitt
- Thomas Alan Dickey
All providers in Cheney, WA · Physical Therapy Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.