Provider Demographics
NPI:1699084384
Name:LEWANDOWSKI, ANGELA MARY (PT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARY
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7141 SPRING MEADOWS W DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9295
Mailing Address - Country:US
Mailing Address - Phone:419-865-9425
Mailing Address - Fax:419-865-9457
Practice Address - Street 1:7141 SPRING MEADOWS W DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9295
Practice Address - Country:US
Practice Address - Phone:419-865-9425
Practice Address - Fax:419-865-9457
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-013045225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist