NPI 1255169421

Angelo C Mack, LMT

Practitioner Massage Therapist Gulfport, MS

Practice location

Address: 2033 E Pass Rd STE C, Gulfport, MS 39507-3714
Phone: (228) 313-1763
Mailing address: 242 McDonnell Ave APT A18, Biloxi, MS 39531-4218

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 3787 (MS)

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Registry record

NPI: 1255169421
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jul 2024
Record last updated: 22 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.