Provider Demographics
NPI:1619165933
Name:TRAIL, ANGEL ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:ELIZABETH
Last Name:TRAIL
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 1:7 GARRISON ROAD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9215
Mailing Address - Country:US
Mailing Address - Phone:828-675-6875
Mailing Address - Fax:828-658-5040
Practice Address - Street 1:7 GARRISON ROAD
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9215
Practice Address - Country:US
Practice Address - Phone:828-675-6875
Practice Address - Fax:828-658-5040
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist