Provider Demographics
NPI:1992187975
Name:MINELLA, ANGELO (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:MINELLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 HAZELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2967
Mailing Address - Country:US
Mailing Address - Phone:412-422-4321
Mailing Address - Fax:
Practice Address - Street 1:828 HAZELWOOD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2967
Practice Address - Country:US
Practice Address - Phone:412-422-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011032111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation