Healthcare Provider Details

I. General information

NPI: 1881079549
Provider Name (Legal Business Name): ANNA WORTHINGTON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WHITE BRIDGE PIKE STE 206
NASHVILLE TN
37205-1467
US

IV. Provider business mailing address

1034 S BRENTWOOD BLVD SUITE 300
SAINT LOUIS MO
63117-1223
US

V. Phone/Fax

Practice location:
  • Phone: 615-356-9935
  • Fax: 615-746-1614
Mailing address:
  • Phone: 314-644-1978
  • Fax: 314-644-5730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11390
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: