Healthcare Provider Details

I. General information

NPI: 1275449183
Provider Name (Legal Business Name): ANTHONY CLINE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 WASHINGTON SQ
EVANSVILLE IN
47715-6809
US

IV. Provider business mailing address

1468 N SUNRISE DR
BOWLING GREEN KY
42101-2746
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-5200
  • Fax:
Mailing address:
  • Phone: 270-608-1346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number009583
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: