Provider Demographics
NPI:1285937102
Name:PLUMMER, ANNE ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2550 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-8695
Mailing Address - Country:US
Mailing Address - Phone:616-252-5630
Mailing Address - Fax:616-252-5666
Practice Address - Street 1:1760 FOREST RIDGE DR
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-4773
Practice Address - Country:US
Practice Address - Phone:231-922-3655
Practice Address - Fax:231-922-3657
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist