Individual
MR. CRISENCIANO ANGELO PANES CANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 SLAYDEN ST APT 7, BROWNWOOD, TX 76801-5522
(325) 203-0351
Mailing address
5900 W SAMPLE RD APT 304, CORAL SPRINGS, FL 33067-3268
(325) 203-0351
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2110137
TX
Other
Enumeration date
07/26/2015
Last updated
07/26/2015
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