Provider Demographics
NPI:1811022106
Name:MARROW, ANGELA DAWN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DAWN
Last Name:MARROW
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4919 W 1120 N
Mailing Address - Street 2:
Mailing Address - City:NEWPALESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:46163
Mailing Address - Country:US
Mailing Address - Phone:317-861-6958
Mailing Address - Fax:317-861-1097
Practice Address - Street 1:4919 W 1120 N
Practice Address - Street 2:
Practice Address - City:NEWPALESTINE
Practice Address - State:IN
Practice Address - Zip Code:46163
Practice Address - Country:US
Practice Address - Phone:317-861-6958
Practice Address - Fax:317-861-1097
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002955A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant