Provider Demographics
NPI:1023717154
Name:CIPKAR, ANNA (PT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CIPKAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18753 SHREWSBURY DR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3392
Mailing Address - Country:US
Mailing Address - Phone:734-679-7831
Mailing Address - Fax:
Practice Address - Street 1:18753 SHREWSBURY DR
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3392
Practice Address - Country:US
Practice Address - Phone:734-679-7831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011356225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist