Provider Demographics
NPI:1639275159
Name:DENNIS, ANNE E (MS PT)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:E
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:E
Other - Last Name:LEMASTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, PT
Mailing Address - Street 1:3898 NEW VISIONS DRIVE
Mailing Address - Street 2:SUITE D HANDS ON PHYSICAL THERAPY
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845
Mailing Address - Country:US
Mailing Address - Phone:260-483-1010
Mailing Address - Fax:260-483-1011
Practice Address - Street 1:3898 NEW VISIONS DRIVE
Practice Address - Street 2:SUITE D HANDS ON PHYSICAL THERAPY
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845
Practice Address - Country:US
Practice Address - Phone:260-483-1010
Practice Address - Fax:260-483-1011
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002425A174400000X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000245358OtherANTHEM PIN NUMBER
IN200431440Medicaid
IN156562Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER