Provider Demographics
NPI:1316011968
Name:REMINGTON, ANGELA DAWN (PT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 EAST 81ST STREET SUITE 300
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4230
Mailing Address - Country:US
Mailing Address - Phone:918-477-5041
Mailing Address - Fax:918-477-5940
Practice Address - Street 1:2408 EAST 81ST STREET SUITE 300
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4230
Practice Address - Country:US
Practice Address - Phone:918-477-5041
Practice Address - Fax:918-477-5940
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist