Basic Information
| Provider Information | |||||||||
| NPI: | 1366625527 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AZOTE | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2976 N SCATTERFIELD RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460121585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656438781 | ||||||||
| FaxNumber: | 7656412385 | ||||||||
| Practice Location | |||||||||
| Address1: | 2976 N SCATTERFIELD RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460121585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656438781 | ||||||||
| FaxNumber: | 7656412385 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2007 | ||||||||
| LastUpdateDate: | 12/11/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 05009437A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.