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1194264077
KAREN MANGUM
BOISE, ID
NPI
1194264077
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: ID D-208)
Enumeration Date
2017-02-13
Last Update Date
2017-02-13
Business Address
-- KAREN MANGUM M.S., R.D.N., L.D.
115 N. MAIN STREET SUITE #203
BOISE, ID 83702
Phone number: 208-381-8330
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Mailing Address
-- KAREN MANGUM M.S., R.D.N., L.D.
4726 W CLEAR FIELD DR
EAGLE, ID 83616-6957
Phone number: 208-440-5041
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