Individual
MICHELLE RENEE ANGILLETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1525 12TH ST STE 2A, FLORENCE, OR 97439-9498
(541) 997-1214
Mailing address
PO BOX 1126, FLORENCE, OR 97439-0055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12008
OR
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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