Provider Demographics
NPI:1033465836
Name:BANNIGAN, ANNA (PT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BANNIGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BARTOLOMEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3455 LUTHERAN PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6028
Mailing Address - Country:US
Mailing Address - Phone:303-456-6000
Mailing Address - Fax:303-420-2279
Practice Address - Street 1:3455 LUTHERAN PKWY STE 105
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6028
Practice Address - Country:US
Practice Address - Phone:034-566-0003
Practice Address - Fax:303-420-2279
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10961225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist