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NPI Code Detail

MEDICARE: ANGEL KILLIAN CMT

MEDICARE:   ANGEL  KILLIAN  CMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist2021-0083CA

General Provider Information

NPI Number : 1487403853
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGEL KILLIAN CMT
Provider Business Mailing Address
First Line : PO BOX 202
Second Line :
City : NORTH FORK
State : CA
Zip : 93643-0202
Country : US
Telephone Number : 559-760-0927
Fax Number :
Provider Business Practice Location Address
First Line : 32938 ROAD 222
Second Line :
City : NORTH FORK
State : CA
Zip : 93643-9562
Country : US
Telephone Number : 559-760-0927
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2024
Last Update Date : 05/16/2024

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Directions to “ ANGEL KILLIAN CMT” Practice Location

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