Provider Demographics
NPI:1558310227
Name:THELEN, ANGELA KRISTY (ATC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:KRISTY
Last Name:THELEN
Suffix:
Gender:F
Credentials:ATC
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Mailing Address - Street 1:7081 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAINGSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48848-9222
Mailing Address - Country:US
Mailing Address - Phone:517-651-6029
Mailing Address - Fax:
Practice Address - Street 1:1720 ABBEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6363
Practice Address - Country:US
Practice Address - Phone:517-333-6692
Practice Address - Fax:517-333-6705
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer