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General NPI Number Information
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NPI Number | 1962655852
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Entity Type | Organization
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Legal Business Name | ANGELIC REHABILITATION SERVICES LLC
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 86 COLUMBUS CIRCLE
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City | ATHENS
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State | OH
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Zip | 45701-1331
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Country | US
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Telephone | 740-249-4081
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Fax | 740-249-4126
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Provider Business Mailing Address
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Address Line | PO BOX 742
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City | ATHENS
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State | OH
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Zip | 45701-0742
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Country | US
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Telephone | 740-249-4081
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Fax | 740-249-4126
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELA MARIE THOMAS
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Credential | PT
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Telephone | 740-249-4081
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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 | 008857
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License Number State | OH
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