Provider Demographics
NPI:1417122250
Name:COURTER, ANNE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:COURTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANNE MARIE
Other - Middle Name:
Other - Last Name:KOEHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2945 JUNIPERO SERRA BLVD
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-2549
Mailing Address - Country:US
Mailing Address - Phone:650-755-8830
Mailing Address - Fax:650-755-8147
Practice Address - Street 1:4901 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-1392
Practice Address - Country:US
Practice Address - Phone:608-395-3531
Practice Address - Fax:608-223-3540
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT39564225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist