Provider Demographics
NPI:1558062869
Name:GEORGE, ANNA
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25444 COUNTY ROAD 157
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:MN
Mailing Address - Zip Code:56331-9603
Mailing Address - Country:US
Mailing Address - Phone:218-341-4268
Mailing Address - Fax:
Practice Address - Street 1:3365 W SAINT GERMAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-8510
Practice Address - Country:US
Practice Address - Phone:218-341-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty