Provider Demographics
NPI:1508357682
Name:COLONNA, ANN (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:COLONNA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BROOKLEIGH CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-1247
Mailing Address - Country:US
Mailing Address - Phone:336-414-3102
Mailing Address - Fax:
Practice Address - Street 1:850 BROOKLEIGH CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-1247
Practice Address - Country:US
Practice Address - Phone:336-414-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program