Individual
MRS. AMANDA SHARON LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
315 N RIDGEWOOD AVE, EDGEWATER, FL 32132-1617
(386) 427-8403
Mailing address
2811 VISTA PALM DR, EDGEWATER, FL 32141-5513
(386) 314-0227
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA34247
FL
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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