Provider Demographics
NPI:1821606468
Name:ALDRIDGE, ANNA (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 SHARLANDS AVE APT A2005
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-3706
Mailing Address - Country:US
Mailing Address - Phone:515-490-4583
Mailing Address - Fax:
Practice Address - Street 1:10051 LAKE AVE STE 3
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4870
Practice Address - Country:US
Practice Address - Phone:530-587-7461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer