Individual
ANGELA SPROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
46 FAIRGROUND RD, GLENVILLE, WV 26351-1373
(304) 462-5718
Mailing address
808 LITTLE BULL RUN RD, GLENVILLE, WV 26351-8206
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001111
WV
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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