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NPI Code Detail

MEDICARE: ANGELA RENEE STALEY PTA

MEDICARE: ANGELA RENEE STALEY PTA
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
1225200000XPhysical Therapy Assistant14-03479KS
2225200000XPhysical Therapy Assistant002079GA
3225200000XPhysical Therapy Assistant3046NC
4225200000XPhysical Therapy AssistantCP008048AMO

General Provider Information

NPI Number : 1437277605
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA RENEE STALEY PTA
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 7932 N OAK TRFY STE 212
Second Line :
City : KANSAS CITY
State : MO
Zip : 64118-1424
Country : US
Telephone Number : 816-399-0806
Fax Number : 816-743-7413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 09/24/2021

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Directions to “ ANGELA RENEE STALEY PTA” Practice Location

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