Provider Demographics
NPI:1841203999
Name:SEDGWICK, ANGELA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LEE
Last Name:SEDGWICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24300 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5639
Mailing Address - Country:US
Mailing Address - Phone:216-220-8769
Mailing Address - Fax:216-342-7077
Practice Address - Street 1:24300 CHAGRIN BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5639
Practice Address - Country:US
Practice Address - Phone:216-220-8769
Practice Address - Fax:216-342-7077
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009665111N00000X
MD03517111N00000X
OH4278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor