Individual
ANGELA JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
622 FOREST DR, FENTON, MI 48430-1837
(734) 778-4820
Mailing address
622 FOREST DR, FENTON, MI 48430-1837
(734) 778-4820
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501001134
MI
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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