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NPI 1417188798

NPI 1417188798 : ANGIE STURGILL PTA : ASHLAND, OH

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General NPI Number Information
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    NPI Number           |    1417188798
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    Entity Type          |    Individual 
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    Provider Name        |    ANGIE STURGILL PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/04/2009
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    Last Update Date     |    08/04/2009
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Provider Practice Location Address
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    Address Line         |    1083 TOWNSHIP ROAD 1806 
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    City                 |    ASHLAND
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    State                |    OH
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    Zip                  |    44805-9404
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    Country              |    US
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    Telephone            |    567-203-7859
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1083 TOWNSHIP ROAD 1806 
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    City                 |    ASHLAND
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    State                |    OH
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    Zip                  |    44805-9404
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    Country              |    US
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    Telephone            |    567-203-7859
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    Fax                  |    
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    05892
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    License Number State |    OH
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