Provider Demographics
NPI:1700446242
Name:KINDER, ANGELA N (LMT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:N
Last Name:KINDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 LINDELL DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45327-1612
Mailing Address - Country:US
Mailing Address - Phone:937-673-7327
Mailing Address - Fax:
Practice Address - Street 1:5900 LONG MEADOW DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-9687
Practice Address - Country:US
Practice Address - Phone:937-673-7327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.017189225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist