Provider Demographics
NPI:1235697152
Name:WEDDLE, ANGELA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WEDDLE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1707
Mailing Address - Country:US
Mailing Address - Phone:606-305-1528
Mailing Address - Fax:
Practice Address - Street 1:371 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BRODHEAD
Practice Address - State:KY
Practice Address - Zip Code:40409-8893
Practice Address - Country:US
Practice Address - Phone:606-758-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-10
Last Update Date:2019-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics