Provider Demographics
NPI:1083758221
Name:LAUER, ANNE BLAKE STEVENS (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:BLAKE STEVENS
Last Name:LAUER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:BLAKE
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3218 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7367
Mailing Address - Country:US
Mailing Address - Phone:325-949-7208
Mailing Address - Fax:
Practice Address - Street 1:120 E HARRIS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5904
Practice Address - Country:US
Practice Address - Phone:325-657-5281
Practice Address - Fax:325-657-8330
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1042612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist