Provider Demographics
NPI:1013212208
Name:REMMICK, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:REMMICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:EWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:309 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56278-1357
Mailing Address - Country:US
Mailing Address - Phone:320-839-4271
Mailing Address - Fax:
Practice Address - Street 1:15620 EDGEWOOD DR
Practice Address - Street 2:SUITE 240
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-6967
Practice Address - Country:US
Practice Address - Phone:218-454-7012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist