Provider Demographics
NPI:1952792046
Name:ANGALICH, GEORGE M (DPT)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:ANGALICH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN DALE
Mailing Address - State:WV
Mailing Address - Zip Code:26038-1326
Mailing Address - Country:US
Mailing Address - Phone:304-281-3648
Mailing Address - Fax:
Practice Address - Street 1:16251 N CLEVELAND AVE STE 1-4
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-2176
Practice Address - Country:US
Practice Address - Phone:239-731-6222
Practice Address - Fax:239-731-6555
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT003414225100000X
FLPT40765225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist