Provider Demographics
NPI:1144355538
Name:POWERS, ANGELA MICHELLE (MPT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MICHELLE
Last Name:POWERS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MICHELLE
Other - Last Name:CYRUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:4466 W BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3170
Mailing Address - Country:US
Mailing Address - Phone:810-733-1200
Mailing Address - Fax:810-733-0688
Practice Address - Street 1:307 S COURT ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2514
Practice Address - Country:US
Practice Address - Phone:810-603-1000
Practice Address - Fax:810-603-1101
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist