Provider Demographics
NPI:1730864539
Name:ANGLE, DENA (LPTA)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:ANGLE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10540 S POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:GLOUSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45732-9330
Mailing Address - Country:US
Mailing Address - Phone:740-856-7329
Mailing Address - Fax:
Practice Address - Street 1:51 E 4TH ST
Practice Address - Street 2:
Practice Address - City:THE PLAINS
Practice Address - State:OH
Practice Address - Zip Code:45780-1346
Practice Address - Country:US
Practice Address - Phone:740-797-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3773225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant