Provider Demographics
NPI:1326196403
Name:EUREKA, ANNE MARIE (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:EUREKA
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3956 SLEEPY HOLLOW ROAD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK HILLS TWP.
Mailing Address - State:OH
Mailing Address - Zip Code:44212-4077
Mailing Address - Country:US
Mailing Address - Phone:330-273-3775
Mailing Address - Fax:
Practice Address - Street 1:1000 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2170
Practice Address - Country:US
Practice Address - Phone:220-225-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00066225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant