Anne Clark, DPT
Individual provider Active NPI Physical Therapist · Derby, KS
NPI 1104471838 · NPPES record last updated Aug 8, 2019
Key facts
- NPI
- 1104471838
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-04920 (KS)
- Practice address
- 234 W Greenway St
Derby, KS 67037-2641 - Phone
- (316) 788-6734
- NPI assigned
- Aug 8, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-04920 | KS | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-04920 | KS | Yes |
Addresses
Primary practice location
234 W Greenway St
Derby, KS 67037-2641
Mailing address
234 W Greenway St
Derby, KS 67037-2641
Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.