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NPI Code Detail

MEDICARE: ANGELA MACKAY PT, DPT

MEDICARE: ANGELA MACKAY PT, DPT
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
1225100000XPhysical TherapistPTL.0017760CO
2225100000XPhysical TherapistPT029575PA

General Provider Information

NPI Number : 1295306892
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA MACKAY PT, DPT
Provider Business Mailing Address
First Line : 9265 ABBEY RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-1127
Country : US
Telephone Number : 440-773-4843
Fax Number :
Provider Business Practice Location Address
First Line : 1645 W 8TH ST
Second Line :
City : ERIE
State : PA
Zip : 16505-5097
Country : US
Telephone Number : 814-875-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2021
Last Update Date : 07/05/2021

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