Provider Demographics
NPI:1306844329
Name:KINZER, ANGELA M (MS PT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:KINZER
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:BIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS PT
Mailing Address - Street 1:1815 N CAPITOL AVE
Mailing Address - Street 2:STE 600
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1465
Mailing Address - Country:US
Mailing Address - Phone:317-924-8636
Mailing Address - Fax:317-921-0237
Practice Address - Street 1:1815 N CAPITOL AVE
Practice Address - Street 2:STE 600
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1465
Practice Address - Country:US
Practice Address - Phone:317-924-8636
Practice Address - Fax:317-921-0237
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006931A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000320485OtherANTHEM BCBS
INDB9030OtherRAILROAD MEDICARE
IN000000320485OtherANTHEM BCBS