Provider Demographics
NPI:1053717447
Name:SPEER, ANNA ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ELIZABETH
Last Name:SPEER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PILOT HOUSE PL
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-7058
Mailing Address - Country:US
Mailing Address - Phone:724-422-1076
Mailing Address - Fax:
Practice Address - Street 1:9405 HIGHWAY 17 BYP
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-9301
Practice Address - Country:US
Practice Address - Phone:843-650-2213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5868225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist