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Individual

ANGEL MARIE VANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.A

Contact information

Practice address
1331 TRUMBULL ST STE 100, DETROIT, MI 48216-1376
(313) 962-9050
Mailing address
19977 HUDSON BAY, CLINTON TWP, MI 48038-1493
(586) 416-1990

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
04870
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04870
OHIO PHYSICAL THERAPY
OH
Enumeration date
06/04/2007
Last updated
07/08/2007
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