SCOTT RYAN MANGUM

BLACKFOOT, ID
NPI1043180730
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  7371782)
Enumeration Date2025-11-07
Last Update Date2025-11-07
Business Address
SCOTT RYAN MANGUM PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1799
Phone number: 208-785-4100
Mailing Address
SCOTT RYAN MANGUM PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1799
Phone number: 208-785-4100
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