Provider Demographics
NPI:1871976712
Name:ANGELL, BRIAN (CPO, CPED)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:ANGELL
Suffix:
Gender:M
Credentials:CPO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 S CHILLICOTHE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8830
Mailing Address - Country:US
Mailing Address - Phone:330-562-2455
Mailing Address - Fax:330-562-2514
Practice Address - Street 1:199 S CHILLICOTHE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8830
Practice Address - Country:US
Practice Address - Phone:330-562-2455
Practice Address - Fax:330-562-2514
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPO 297222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist