Healthcare Provider Details

I. General information

NPI: 1457828014
Provider Name (Legal Business Name): ANNA LOVOTTI PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 N WASHINGTON AVE
DALLAS TX
75246-1520
US

IV. Provider business mailing address

3301 HUDNALL ST APT 9202
DALLAS TX
75235-9217
US

V. Phone/Fax

Practice location:
  • Phone: 413-433-1338
  • Fax:
Mailing address:
  • Phone: 413-433-1338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number1308168
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: