Most Relevant Information
Provider Data
| NPI Number: | 1003473000 |
| Provider Name: | ANGELICA SALAS |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/24/2019 |
| Last Updated: | 05/28/2019 |
Provider Practice Location
2814 WOODCLIFF CIR SE
GRAND RAPIDS
MI
495063155
Practice Location Phone/Fax
| Phone: | 8558326727 |
| Fax: |
Provider Mailing Location
3539 RICHMOND ST NW
WALKER
MI
495341208
Provider Mailing Phone/Fax
| Phone: | 6166498724 |
| Fax: |