Individual
ANGELLA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
23819 W MILL ST, SUITE 7, PLAINFIELD, IL 60544-3457
(815) 408-0071
Mailing address
1400 N ROCK RUN DR, APT. D2, CREST HILL, IL 60403-8322
(708) 341-2026
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227005736
IL
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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