Healthcare Provider Details

I. General information

NPI: 1578529293
Provider Name (Legal Business Name): ANNA LOREN KAUS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4076 NEELEY ROAD
APO AA
99703
US

IV. Provider business mailing address

1007 AKIAK AVE
FAIRBANKS AK
99701-1417
US

V. Phone/Fax

Practice location:
  • Phone: 907-361-5237
  • Fax:
Mailing address:
  • Phone: 708-275-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070013857
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: