IndividualActive
Angelina Wills, ATC
NPI 1003170622 · Specialist · Saint Louis, MO
Provider details
- NPI number
- 1003170622
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2005005317 (MO)
Specialties & taxonomies
Other Service Providers
Practice location
3330 Laclede Ave
Chaifetz Arena
Saint Louis, MO 63103-2014
Phone: (314) 977-7018
Fax: (314) 977-3183
Approximate (ZIP-level) locationGet directions
Mailing address
3330 Laclede Ave
Saint Louis, MO 63103-2014
Registry dates
- Enumerated
- 2012-06-28
- Last updated
- 2012-06-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.