Provider Demographics
NPI:1962693556
Name:BOSTER, ANNE MARIE (PT)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:BOSTER
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 1:1609 WOODSPOINTE CIR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-2822
Mailing Address - Country:US
Mailing Address - Phone:251-343-0909
Mailing Address - Fax:
Practice Address - Street 1:1609 WOODSPOINTE CIR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2822
Practice Address - Country:US
Practice Address - Phone:251-343-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19042251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics