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General NPI Number Information
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NPI Number | 1386965317
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Entity Type | Individual
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Provider Name | ANGELA MARIE CONEY LMT
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Gender | Female
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 1360 US HIGHWAY 1 SUITE 5
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City | VERO BEACH
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State | FL
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Zip | 32960-5703
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Country | US
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Telephone | 772-569-7770
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Fax | 772-569-7770
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Provider Business Mailing Address
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Address Line | 8303 FORT WALTON AVE
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City | FORT PIERCE
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State | FL
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Zip | 34951-1397
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Country | US
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Telephone | 772-429-1149
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Fax | 772-429-1149
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 50066
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License Number State | FL
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