Individual
MRS. ANGI RENEE VARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4343 KENNEDY DR, EAST MOLINE, IL 61244-4203
(309) 796-6600
Mailing address
4560 SE INTERNATIONAL WAY, STE. 100, MILWAUKIE, OR 97222
(971) 206-5200
(971) 206-5203
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
00773
IA
225200000X
Physical Therapy Assistant
Primary
160.003734
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160.003734
PTA LICENSE
IL
Enumeration date
11/16/2011
Last updated
09/28/2020
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