Individual
ANGELA V. FORMAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
250 CETRONIA RD, ALLENTOWN, PA 18104-9147
(610) 973-6200
Mailing address
1045 N WAHNETA ST, ALLENTOWN, PA 18109-1668
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003528
PA
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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