Provider Demographics
NPI:1912109349
Name:REED, ANGELA LYNN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LYNN
Last Name:REED
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
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Mailing Address - Street 1:25302 NOBLE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-3260
Mailing Address - Country:US
Mailing Address - Phone:586-405-0818
Mailing Address - Fax:
Practice Address - Street 1:17900 23 MILE RD
Practice Address - Street 2:SUITE 401
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-1161
Practice Address - Country:US
Practice Address - Phone:586-868-9040
Practice Address - Fax:586-868-9013
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant