Provider Demographics
NPI:1629328901
Name:MESSERLY, ANNA CHRISTINE (DPT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINE
Last Name:MESSERLY
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 1:1125 CEDAR ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-4663
Mailing Address - Country:US
Mailing Address - Phone:763-295-4201
Mailing Address - Fax:763-295-3895
Practice Address - Street 1:1125 CEDAR ST
Practice Address - Street 2:SUITE 106
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-4663
Practice Address - Country:US
Practice Address - Phone:763-295-4201
Practice Address - Fax:763-295-3895
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist