Provider Demographics
NPI:1982830832
Name:VOGEL, ANGELA RENEE KOLTER (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RENEE KOLTER
Last Name:VOGEL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:RENEE
Other - Last Name:KOLTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:7235 MAPLES RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46816-9504
Mailing Address - Country:US
Mailing Address - Phone:260-920-2573
Mailing Address - Fax:260-920-2633
Practice Address - Street 1:1316 E 7TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2523
Practice Address - Country:US
Practice Address - Phone:260-920-2573
Practice Address - Fax:260-920-2633
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008571A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist