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General NPI Number Information
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NPI Number | 1720074511
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Entity Type | Individual
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Provider Name | ANNE COAKLEY PT
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Gender | Female
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 6011 UNIVERSITY BLVD SUITE 120
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6074
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Country | US
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Telephone | 410-203-0391
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Fax | 410-203-2707
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Provider Business Mailing Address
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Address Line | 3901 NATIONAL DR STE 100
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1176
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Country | US
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Telephone | 301-421-1125
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Fax | 301-500-2175
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 16463
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 16463
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License Number State | MD
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