Provider Demographics
NPI:1356908446
Name:ALBERTINI, ANGIE (PTA)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:ALBERTINI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2602
Mailing Address - Country:US
Mailing Address - Phone:614-515-0341
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:2340 AIRPORT DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2602
Practice Address - Country:US
Practice Address - Phone:614-515-0341
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012141225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant