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General NPI Number Information
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NPI Number | 1659037687
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Entity Type | Individual
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Provider Name | ANGELICA WEATHERSPOON PT
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Gender | Female
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 1718 VETERANS MEMORIAL PKWY STE A
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City | TUSCALOOSA
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State | AL
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Zip | 35404-4792
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Country | US
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Telephone | 205-270-5146
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Fax |
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Provider Business Mailing Address
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Address Line | 16306 HIGHWAY 69 S
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City | MOUNDVILLE
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State | AL
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Zip | 35474-6213
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Country | US
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Telephone | 205-861-6523
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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