Individual
MRS. ANGELA S WANLESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 TRUXTON AVE, FORT WALTON BEACH, FL 32547-2460
(850) 305-6006
Mailing address
343 KEPNER DR NE, FORT WALTON BEACH, FL 32548-5144
(850) 243-1140
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA31729
FL
Other
Enumeration date
03/07/2008
Last updated
03/07/2008
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