Individual
ANGELA MARIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
131 COVENANT WAY, BUMPASS, VA 23024-4618
(571) 685-9867
Mailing address
514 AMERICAS WAY, BOX ELDER, SD 57719-7600
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019012674
VA
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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