MEDICARE: ANNA LOREN POSSEMATO PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070013857	IL

General Provider Information

NPI Number	:	1578529293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA LOREN POSSEMATO PT, DPT

Provider Business Mailing Address
First Line	:	1007 AKIAK AVE
Second Line	:
City	:	FAIRBANKS
State	:	AK
Zip	:	99701-1417
Country	:	US
Telephone Number	:	708-275-0191
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 W POPLAR AVE
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2540
Country	:	US
Telephone Number	:	901-850-5246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	01/12/2026

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