Individual
THERESA ANGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
267 SLICKBACK RD, BENTON, KY 42025-7629
(270) 527-1496
(270) 527-5321
Mailing address
267 SLICKBACK RD, BENTON, KY 42025-7629
(270) 527-1496
(270) 527-5321
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2024331
KY
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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