Provider Demographics
NPI:1306157482
Name:WHITTINGTON, ANGELA GAYLE (ATC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:GAYLE
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3884 SUGAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-2013
Mailing Address - Country:US
Mailing Address - Phone:614-432-9113
Mailing Address - Fax:
Practice Address - Street 1:3884 SUGAR CREEK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-2013
Practice Address - Country:US
Practice Address - Phone:614-432-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer