Provider Demographics
NPI:1093864738
Name:PARKER, ANN MARIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 N MT TABOR RD
Mailing Address - Street 2:
Mailing Address - City:ELLETTSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47429-9542
Mailing Address - Country:US
Mailing Address - Phone:812-360-3646
Mailing Address - Fax:
Practice Address - Street 1:8550 N MT TABOR RD
Practice Address - Street 2:
Practice Address - City:ELLETTSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47429-9542
Practice Address - Country:US
Practice Address - Phone:812-360-3646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002375A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist