Provider Demographics
NPI:1629750278
Name:BANEY, ANNE COLETTE (DPT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:COLETTE
Last Name:BANEY
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 1:5 KEITH CT
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-8542
Mailing Address - Country:US
Mailing Address - Phone:610-781-8186
Mailing Address - Fax:
Practice Address - Street 1:870 GORDON NAGLE TRL
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-4203
Practice Address - Country:US
Practice Address - Phone:570-399-5331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist