Individual
ANGELA D HANNULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
200 ROBINSON ST STE D300, BASALT, CO 81621-8464
(970) 718-7100
Mailing address
PO BOX 40000, VAIL, CO 81658-7520
(970) 476-2451
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL10444
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12249751
CAQH
CO
01
—
775826
UNITEDE HEALTH
CO
Enumeration date
08/20/2009
Last updated
04/20/2022
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