Provider Demographics
NPI:1952324345
Name:VOGEL, ANGELA CHRISTINE (PT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:CHRISTINE
Other - Last Name:VIERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:219-213-3942
Mailing Address - Fax:219-213-3943
Practice Address - Street 1:856 N SUPERIOR DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8299
Practice Address - Country:US
Practice Address - Phone:219-213-3942
Practice Address - Fax:219-213-3943
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009146A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000489551OtherANTHEM - APT PLUS
IN000000489405OtherANTHEM - 1ST AID PLUS
IN000000487256OtherANTHEM - MBWOUDE
IN214680TMedicare ID - Type UnspecifiedPART B GROUP MEMBER
IN000000489551OtherANTHEM - APT PLUS
IN000000489405OtherANTHEM - 1ST AID PLUS
IN214690TMedicare ID - Type UnspecifiedPART B GROUP MEMBER