Individual
DR. ANGELIQUE WITLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATP
Contact information
Practice address
906 W. EXECUTIVE COURT, MONTICELLO, IN 47960
(574) 583-9950
(574) 583-9951
Mailing address
2380 S ROBERTS WAY, LOGANSPORT, IN 46947-6626
(574) 753-0466
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05005405A
IN
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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