Healthcare Provider Details

I. General information

NPI: 1346579216
Provider Name (Legal Business Name): ANGELA BAHR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 86TH ST
URBANDALE IA
50322-4204
US

IV. Provider business mailing address

2714 INGERSOLL AVE APT 17
DES MOINES IA
50312-5256
US

V. Phone/Fax

Practice location:
  • Phone: 515-276-3406
  • Fax:
Mailing address:
  • Phone: 515-240-3793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004476
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: