Provider Demographics
NPI:1447021969
Name:SIZEMORE, ANGELA HODGES
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:HODGES
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 HULL STREET RD STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1247
Mailing Address - Country:US
Mailing Address - Phone:804-397-9895
Mailing Address - Fax:
Practice Address - Street 1:9415 HULL STREET RD STE C
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-1247
Practice Address - Country:US
Practice Address - Phone:804-397-9895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019003563225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty