Individual
ANGELA S THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-015115
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00865614
MEDICARE RR
IL
Enumeration date
05/29/2008
Last updated
12/09/2010
Update your record
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