Provider Demographics
NPI:1114250289
Name:MARSH, ANGELA DENISE (PTA)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:DENISE
Last Name:MARSH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:DENISE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4988 HIGHSADDLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8724
Mailing Address - Country:US
Mailing Address - Phone:330-324-2514
Mailing Address - Fax:
Practice Address - Street 1:6057 STRIP AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720
Practice Address - Country:US
Practice Address - Phone:330-492-8136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA 3224225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant