Provider Demographics
NPI:1699042861
Name:ANGEL, MARIA C (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:ANGEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 876424
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-6424
Mailing Address - Country:US
Mailing Address - Phone:907-414-5840
Mailing Address - Fax:888-615-6351
Practice Address - Street 1:5099 E BLUE LUPINE DR
Practice Address - Street 2:STE 116
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8449
Practice Address - Country:US
Practice Address - Phone:907-414-5840
Practice Address - Fax:888-615-6351
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK575111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty