Provider Demographics
NPI:1629804885
Name:HULETT, ANGELICA R (BSK, DPT)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:R
Last Name:HULETT
Suffix:
Gender:F
Credentials:BSK, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 N MULLAN RD STE 4
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-3857
Mailing Address - Country:US
Mailing Address - Phone:509-892-5442
Mailing Address - Fax:509-892-5462
Practice Address - Street 1:626 N MULLAN RD STE 4
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-3857
Practice Address - Country:US
Practice Address - Phone:509-892-5442
Practice Address - Fax:509-892-5462
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist