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1871008169
ANGEL LY
TAMPA, FL
NPI
1871008169
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL AL4485)
Enumeration Date
2017-12-08
Last Update Date
2017-12-08
Business Address
ANGEL LY ATC, LAT
4202 E FOWLER AVE STOP ATH100
TAMPA, FL 33620-8455
Phone number: 813-974-0661
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Mailing Address
ANGEL LY ATC, LAT
2028 BLUE ROCK DR APT 204
TAMPA, FL 33612-5144
Phone number:
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