Provider Demographics
NPI:1700223997
Name:WHITNEY, ANNA LYNNE (AT, ATC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LYNNE
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:AT, ATC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LYNNE
Other - Last Name:QUICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4270 FORT AMANDA RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-4090
Mailing Address - Country:US
Mailing Address - Phone:419-979-8735
Mailing Address - Fax:
Practice Address - Street 1:4270 FORT AMANDA RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-4090
Practice Address - Country:US
Practice Address - Phone:419-979-8735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer