Individual
ANGELA VICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6501 LOISDALE CT, SPRINGFIELD, VA 22150-1826
(703) 922-1234
Mailing address
2306 DEFOREST AVE, ANGOLA, IN 46703-2803
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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