Individual
ANGELA MCNEILLY PONCELAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1761 BROADWAY ST, SUITE 210, VALLEJO, CA 94589-2226
(707) 645-2563
Mailing address
1761 BROADWAY ST, SUITE 210, VALLEJO, CA 94589-2226
(707) 645-2563
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
27223
CA
Other
Enumeration date
11/14/2006
Last updated
12/21/2021
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