Jacqueline Ong Ang, PT
Individual provider Active NPI Physical Therapist · Toler, KY
NPI 1295085280 · NPPES record last updated Sep 17, 2012
Key facts
- NPI
- 1295085280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 004944 (KY)
- Practice address
- 52 Toler Loop Apt 1
Toler, KY 41514-8692 - Phone
- (606) 939-0788
- NPI assigned
- Sep 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004944 | KY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004944 | KY | Yes |
Addresses
Primary practice location
52 Toler Loop Apt 1
Toler, KY 41514-8692
Mailing address
52 Toler Loop Apt 1
Toler, KY 41514
Phone (606) 939-0788
Other providers in Toler, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.