Individual
MRS. MARY ANNE ATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2525 CHARLESTOWN RD, NEW ALBANY, IN 47150-2556
(812) 542-3651
(888) 357-6040
Mailing address
2865 S MOUNT ZION CHURCH RD, PEKIN, IN 47165-8111
(812) 704-2806
(888) 357-6040
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
05003245A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05003245A
INDIANA PT LICENSE
IN
01
—
200660710
FIRST STEPS PROVIDER #
IN
01
—
200731960
EMPLOYER FIRST STEP #
IN
Enumeration date
11/04/2006
Last updated
01/19/2020
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