Individual
AMY ANGULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, LPN
Contact information
Practice address
23494 SCHOONER DR, CANYON LAKE, CA 92587-7462
(406) 214-6030
(406) 204-1201
Mailing address
23494 SCHOONER DR, CANYON LAKE, CA 92587-7462
(406) 214-6030
(406) 204-1201
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
73149
CA
225700000X
Massage Therapist
LMT-LMT-LIC-6249
MT
Other
Enumeration date
02/15/2015
Last updated
05/01/2017
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