Provider Demographics
NPI:1043277320
Name:ROETKER, ANNA LOUSIE (ATC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:LOUSIE
Last Name:ROETKER
Suffix:
Gender:F
Credentials:ATC
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11101 REIGER RD
Mailing Address - Street 2:APT 316
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-4590
Mailing Address - Country:US
Mailing Address - Phone:225-266-2809
Mailing Address - Fax:225-763-9757
Practice Address - Street 1:11101 REIGER RD
Practice Address - Street 2:APT 316
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-4590
Practice Address - Country:US
Practice Address - Phone:225-266-2809
Practice Address - Fax:225-763-9757
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer