Individual
MRS. ANGELA BLAIR WULKOPF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
900 ANSON ST, SALEM, IN 47167-1982
(812) 883-4681
(812) 883-8113
Mailing address
6740 BROOKSIDE DR NE, LANESVILLE, IN 47136-8902
(812) 952-1211
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001953A
IN
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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