Provider Demographics
NPI:1962925883
Name:MYERS, ANGELA M (LMT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 N HOLLAND SYLVANIA RD STE 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1411
Mailing Address - Country:US
Mailing Address - Phone:419-561-4325
Mailing Address - Fax:
Practice Address - Street 1:3409 N HOLLAND SYLVANIA RD STE 3
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1411
Practice Address - Country:US
Practice Address - Phone:419-561-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.022596225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist