Provider Demographics
NPI:1679856488
Name:LEE, ANITA COACHMAN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:COACHMAN
Last Name:LEE
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 1:1475 1ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265
Mailing Address - Country:US
Mailing Address - Phone:256-435-9386
Mailing Address - Fax:256-435-2053
Practice Address - Street 1:1475 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265
Practice Address - Country:US
Practice Address - Phone:256-435-9386
Practice Address - Fax:256-435-2053
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist