Provider Demographics
NPI:1962697870
Name:STYERS, ANGELA MARIE (ATC, MS, LAT)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIE
Last Name:STYERS
Suffix:
Gender:F
Credentials:ATC, MS, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1214
Mailing Address - Street 2:112 HARCOURT RD.
Mailing Address - City:MT. VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050
Mailing Address - Country:US
Mailing Address - Phone:740-392-8811
Mailing Address - Fax:740-392-6485
Practice Address - Street 1:112 HARCOURT RD.
Practice Address - Street 2:
Practice Address - City:MT. VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050
Practice Address - Country:US
Practice Address - Phone:740-392-8811
Practice Address - Fax:740-392-6485
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0020152255A2300X
OHA.T.0020152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer