Individual
MRS. ANGIE NICOLE SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CMMP
Contact information
Practice address
1806 N. MARKET STREET, CHAMPAIGN, IL 61822
(217) 650-9362
Mailing address
1806 N. MARKET STREET, CHAMPAIGN, IL 61822
(217) 650-9362
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
IL227.020137
IL
Other
Enumeration date
07/13/2021
Last updated
03/11/2024
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