Provider Demographics
NPI:1285927137
Name:ATHEY, LINDA D (PTA)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:ATHEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 L ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4114
Mailing Address - Country:US
Mailing Address - Phone:707-465-3311
Mailing Address - Fax:707-464-1804
Practice Address - Street 1:440 L ST
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-4114
Practice Address - Country:US
Practice Address - Phone:707-465-3311
Practice Address - Fax:707-464-1804
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT 2502225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant