Provider Demographics
NPI:1275518441
Name:FELTS, ANNE M (MS, ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:FELTS
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 SPRING MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-8933
Mailing Address - Country:US
Mailing Address - Phone:706-331-0028
Mailing Address - Fax:888-395-1142
Practice Address - Street 1:1353 SPRING MEADOWS DR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8933
Practice Address - Country:US
Practice Address - Phone:706-331-0028
Practice Address - Fax:888-395-1142
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT000332225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAT0000001327OtherSTATE OF TENNESSEE LAT
GAAT000332OtherATHLETIC TRAINER STATE
089402406OtherATC NATIONAL ATHLETIC TRA