Provider Demographics
NPI:1215322292
Name:ATTI, KALLIE (DPT)
Entity type:Individual
Prefix:MRS
First Name:KALLIE
Middle Name:
Last Name:ATTI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3848 LYONS RD APT 304
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4484
Mailing Address - Country:US
Mailing Address - Phone:954-548-5614
Mailing Address - Fax:
Practice Address - Street 1:1955 N FEDERAL HWY UNIT 253
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1036
Practice Address - Country:US
Practice Address - Phone:954-850-2520
Practice Address - Fax:954-850-2521
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 229816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist