Provider Demographics
NPI:1689775355
Name:SNEED, ANGELA SHIRK (ATC, LAT)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SHIRK
Last Name:SNEED
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:LYNN
Other - Last Name:SHIRK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:140 SINGLETON RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6902
Mailing Address - Country:US
Mailing Address - Phone:704-968-2217
Mailing Address - Fax:
Practice Address - Street 1:528 WILLIAMSON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8197
Practice Address - Country:US
Practice Address - Phone:704-968-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC02512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer