Provider Demographics
NPI:1417963844
Name:PLOMINSKI, ANGELA MICHELLE (ATC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MICHELLE
Last Name:PLOMINSKI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 MARIA BLVD
Mailing Address - Street 2:
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403
Mailing Address - Country:US
Mailing Address - Phone:570-906-5215
Mailing Address - Fax:
Practice Address - Street 1:1333 MAIN ST
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452
Practice Address - Country:US
Practice Address - Phone:570-383-8841
Practice Address - Fax:570-383-8979
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0037952255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer