Provider Demographics
NPI:1457109852
Name:SPRACKLIN, ANNA LAUREN (DPT, PT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LAUREN
Last Name:SPRACKLIN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-1495
Mailing Address - Country:US
Mailing Address - Phone:302-389-7855
Mailing Address - Fax:
Practice Address - Street 1:100 S MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1495
Practice Address - Country:US
Practice Address - Phone:302-389-7855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0014879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist