Individual
MRS. MYRA JANE TANGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6272 W WILSON RD, CLIO, MI 48420-9462
(810) 686-9274
Mailing address
6272 W WILSON RD, CLIO, MI 48420-9462
(810) 686-9274
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
740
ND
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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