Provider Demographics
NPI:1952699043
Name:MARCHANT, ANGELA MAE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:MAE
Last Name:MARCHANT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 1705
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414
Mailing Address - Country:US
Mailing Address - Phone:307-587-9866
Mailing Address - Fax:307-587-9867
Practice Address - Street 1:1819 SHERIDAN AVE.
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414
Practice Address - Country:US
Practice Address - Phone:307-587-9866
Practice Address - Fax:307-587-9867
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist