Provider Demographics
NPI:1053058693
Name:EVANS, ANNE B (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:B
Last Name:EVANS
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 1:9781 PINTO CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5442
Mailing Address - Country:US
Mailing Address - Phone:513-205-0672
Mailing Address - Fax:
Practice Address - Street 1:201 MARGE SCHOTT WAY
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8863
Practice Address - Country:US
Practice Address - Phone:513-205-0672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist