Provider Demographics
NPI:1992265250
Name:GEWERTH, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GEWERTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29048 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN
Mailing Address - State:MN
Mailing Address - Zip Code:56266-1311
Mailing Address - Country:US
Mailing Address - Phone:507-276-8432
Mailing Address - Fax:
Practice Address - Street 1:800 E 28TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:612-863-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation