Provider Demographics
NPI:1861047839
Name:COTTLE, ANNA CAROLINE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:CAROLINE
Last Name:COTTLE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 CENTRAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-8801
Mailing Address - Country:US
Mailing Address - Phone:678-983-8886
Mailing Address - Fax:
Practice Address - Street 1:1106 CENTRAL PARK RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-8801
Practice Address - Country:US
Practice Address - Phone:678-983-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014174225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist