Provider Demographics
NPI:1932709029
Name:HELD, ANGELA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HELD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1411 RIDGEWAY RD
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-2636
Mailing Address - Country:US
Mailing Address - Phone:217-853-1751
Mailing Address - Fax:
Practice Address - Street 1:1411 RIDGEWAY RD
Practice Address - Street 2:
Practice Address - City:BOGART
Practice Address - State:GA
Practice Address - Zip Code:30622-2636
Practice Address - Country:US
Practice Address - Phone:217-853-1751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist