Individual
ANGELA RENEE LANDSETTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT 010884
Contact information
Practice address
211 STOCKSDALE DR, MARYSVILLE, OH 43040-5507
(937) 644-3311
(937) 644-0373
Mailing address
211 STOCKSDALE DR, MARYSVILLE, OH 43040-5507
(937) 644-3311
(937) 644-0373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 010884
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000372032
ANTHEM PROVIDER NUMBER
OH
01
—
15668
NATIONWIDE INSURANCE
OH
01
—
23-2804807
REHAB PROVIDER NETWORK
OH
01
—
31-1356625
GREAT WEST HEALTHCARE PRO
OH
01
—
311356625030
CARESOURCE MCO
OH
01
—
685840
UHC
OH
01
—
9401895
PHCS NETWORK
OH
Enumeration date
12/03/2005
Last updated
01/09/2008
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