Provider Demographics
NPI:1083696942
Name:WHERRY, ANNA B (PT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:B
Last Name:WHERRY
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 1:915 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-8318
Mailing Address - Country:US
Mailing Address - Phone:406-782-7839
Mailing Address - Fax:
Practice Address - Street 1:524 E PARK ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1929
Practice Address - Country:US
Practice Address - Phone:406-782-4748
Practice Address - Fax:406-782-4375
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1298PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTMSF1158540OtherWORKERS COMP
MT0340986Medicaid
MT000060298OtherBC/BS
MT0340986Medicaid