Provider Demographics
NPI:1699981266
Name:WEBSTER, ANN MARIE (PT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 W UNION HILLS DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8067
Mailing Address - Country:US
Mailing Address - Phone:928-897-8842
Mailing Address - Fax:
Practice Address - Street 1:6701 W UNION HILLS DR
Practice Address - Street 2:SUITE 2
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8067
Practice Address - Country:US
Practice Address - Phone:928-897-8842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7436174400000X
NV2743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT10868OtherPT LICENSE
AZ7436OtherPT LICENSE
NV2743OtherSTATE OF NEVADA BOARD OF PHYSICAL THERAPY EXAMINERS