Healthcare Provider Details

I. General information

NPI: 1467191353
Provider Name (Legal Business Name): ANNA MARIE MCCLAIN-COKER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA MARIE MCCLAIN DPT

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 W VIRGINIA WAY STE 1
RANSON WV
25438-4882
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 304-728-9090
  • Fax: 304-728-9087
Mailing address:
  • Phone: 630-575-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP050392T
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28966
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number28966
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: