Provider Demographics
NPI:1578556056
Name:ANGELL, JOSEPH ALAN (ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ALAN
Last Name:ANGELL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 GUNDERSEN DR
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8512
Mailing Address - Country:US
Mailing Address - Phone:608-775-8600
Mailing Address - Fax:608-775-8614
Practice Address - Street 1:3111 GUNDERSEN DR
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8512
Practice Address - Country:US
Practice Address - Phone:608-775-8600
Practice Address - Fax:608-775-8614
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0000369-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer