Provider Demographics
NPI:1033230057
Name:SETTLE, ANNETTE MOORE (PT)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MOORE
Last Name:SETTLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4252 WHITEYS WAY
Mailing Address - Street 2:
Mailing Address - City:GOSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:47433-8229
Mailing Address - Country:US
Mailing Address - Phone:812-282-0963
Mailing Address - Fax:812-828-0311
Practice Address - Street 1:4252 WHITEYS WAY
Practice Address - Street 2:
Practice Address - City:GOSPORT
Practice Address - State:IN
Practice Address - Zip Code:47433-8229
Practice Address - Country:US
Practice Address - Phone:812-282-0963
Practice Address - Fax:812-828-0311
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006678A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200705930AMedicare ID - Type UnspecifiedFIRST STEPS