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Individual

ANGELA CONLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3900 S FLORIDA AVE, STE 107, LAKELAND, FL 33813-1151
(863) 647-3665
Mailing address
1524 FERN PL, LAKELAND, FL 33801-2332
(863) 680-1440

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT7164
LICENSE #
FL
Enumeration date
08/25/2006
Last updated
07/08/2007
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