MEDICARE: ANGELA M WESLEY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	010147	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H646381	OTHER	OH	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184761785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M WESLEY PT

Provider Business Mailing Address
First Line	:	PO BOX 378
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44871-0378
Country	:	US
Telephone Number	:	419-626-6161
Fax Number	:	419-502-3511

Provider Business Practice Location Address
First Line	:	3355 RICHMOND RD STE 110
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4180
Country	:	US
Telephone Number	:	216-593-7070
Fax Number	:	216-593-7074

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	04/29/2020

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