Provider Demographics
NPI:1396810396
Name:SCHWEITZER-HENDRIKS, ANGELA MARIKO (MS,OTR/L)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIKO
Last Name:SCHWEITZER-HENDRIKS
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 21
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84629-9513
Mailing Address - Country:US
Mailing Address - Phone:435-469-0614
Mailing Address - Fax:
Practice Address - Street 1:1100 S MEDICAL DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:UT
Practice Address - Zip Code:84647-2222
Practice Address - Country:US
Practice Address - Phone:435-462-2441
Practice Address - Fax:435-462-2609
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT289015-4201208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation