Provider Demographics
NPI:1942331202
Name:KALB, ANNE LOUISE (PTA)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:LOUISE
Last Name:KALB
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9582 SW FLOWERMOUND CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987
Mailing Address - Country:US
Mailing Address - Phone:772-971-7556
Mailing Address - Fax:
Practice Address - Street 1:2484 SE ALLEN ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5210
Practice Address - Country:US
Practice Address - Phone:772-971-7556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20584225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant