Provider Demographics
NPI:1578180105
Name:FRIEL, ANNA ROSE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:ROSE
Last Name:FRIEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:ROSE
Other - Last Name:GIBBONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1643 N ALPINE RD
Mailing Address - Street 2:CORA PHYSICAL THERAPY
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107
Mailing Address - Country:US
Mailing Address - Phone:815-977-4095
Mailing Address - Fax:815-977-4571
Practice Address - Street 1:1643 N ALPINE RD
Practice Address - Street 2:CORA PHYSICAL THERAPY
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107
Practice Address - Country:US
Practice Address - Phone:815-977-4095
Practice Address - Fax:815-977-4571
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-025194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist