Individual
HEIDEROSE A SPANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4601 E ANGELA DR, PHOENIX, AZ 85032-9303
(480) 773-9997
Mailing address
4601 E ANGELA DR, PHOENIX, AZ 85032-9303
(480) 773-9997
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-10555
AZ
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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