Provider Demographics
NPI:1982242210
Name:RUMMELL, ANGELA SARAH (DPT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SARAH
Last Name:RUMMELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:SARAH
Other - Last Name:GAIGNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1450 NORTHWEST BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-5605
Mailing Address - Country:US
Mailing Address - Phone:208-667-6264
Mailing Address - Fax:208-664-4313
Practice Address - Street 1:1450 NORTHWEST BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:COEUR D'ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5605
Practice Address - Country:US
Practice Address - Phone:208-667-6264
Practice Address - Fax:208-664-4313
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer