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NPI Code Detail

MEDICARE: ANGELOS INVESTMENTS, LLC

MEDICARE: ANGELOS INVESTMENTS, LLC
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
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1417490392
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGELOS INVESTMENTS, LLC
Provider Business Mailing Address
First Line : 16201 E INDIANA AVE
Second Line : #3260
City : SPOKANE VALLEY
State : WA
Zip : 99216-2830
Country : US
Telephone Number : 509-315-9119
Fax Number :
Provider Business Practice Location Address
First Line : 16201 E INDIANA AVE
Second Line : #3260
City : SPOKANE VALLEY
State : WA
Zip : 99216-2830
Country : US
Telephone Number : 509-315-9119
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. CHRISTOPHER MANIATAKOS
Credential :
Telephone Number : 509-315-9119
Provider Enumeration Date : 11/28/2016
Last Update Date : 11/28/2016

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Directions to “ANGELOS INVESTMENTS, LLC ” Practice Location

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