Provider Demographics
NPI:1053937805
Name:ZANDERS, ANGELA D (CHLS)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:D
Last Name:ZANDERS
Suffix:
Gender:F
Credentials:CHLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E FORSYTH ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3856
Mailing Address - Country:US
Mailing Address - Phone:229-942-7548
Mailing Address - Fax:
Practice Address - Street 1:1600 E FORSYTH ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3856
Practice Address - Country:US
Practice Address - Phone:229-942-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management