Provider Demographics
NPI:1730988775
Name:BURTON, ANGELA R (PTA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:BURTON
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13540 W CAMINO DEL SOL STE 6
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4435
Mailing Address - Country:US
Mailing Address - Phone:623-566-5013
Mailing Address - Fax:
Practice Address - Street 1:13540 W CAMINO DEL SOL STE 6
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4435
Practice Address - Country:US
Practice Address - Phone:623-566-5013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPTA-011897225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant