William Gerald Angle, OT

Individual provider Active NPI Occupational Therapist · Racine, WI

NPI 1073700522 · NPPES record last updated Oct 9, 2013

Key facts

NPI
1073700522
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
3845-026 (WI)
Practice address
6101 16TH St
Racine, WI 53406-4467
Phone
(262) 898-2770
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
056006744ILMDOccupational Therapist
3845-026WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3845-026 WI Yes
Occupational Therapist 225X00000X 056006744 IL

Addresses

Primary practice location

6101 16TH St
Racine, WI 53406-4467

Mailing address

4848 Riverside Rd
Waterford, WI 53185-3328
Phone (414) 550-1810

Other providers in Racine, WI

All providers in Racine, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.