| Angela Wagner, | |
|
3313 Patriot Ct, Herrin, IL 62948-3782 | |
| (618) 993-9910 | |
| (618) 993-2774 |
| Full Name | Angela Wagner |
|---|---|
| Gender | Female |
| Speciality | Massage Therapist |
| Location | 3313 Patriot Ct, Herrin, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437565025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 227010956 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Wagner, 3313 Patriot Ct, Herrin, IL 62948-3782 Ph: (618) 993-9910 | Angela Wagner, 3313 Patriot Ct, Herrin, IL 62948-3782 Ph: (618) 993-9910 |
Ryan Ijames, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 3313 Patriot Ct, Herrin, IL 62948 Phone: 618-993-9910 Fax: 618-993-2774 | |
Melanie Lentz, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 3313 Patriot Ct, Herrin, IL 62948 Phone: 618-993-9910 Fax: 618-993-2774 | |
Angelique Petree, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 3313 Patriot Ct, Herrin, IL 62948 Phone: 618-993-9910 Fax: 618-993-2774 |