BRAD A MANGUM

SALEM, UT
NPI1316992548
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: UT  5003636-2401)
Enumeration Date2006-05-24
Last Update Date2023-11-27
Business Address
Mr. BRAD A MANGUM P.T.
555 WEST SR 164
SALEM, UT 84653
Phone number: 385-203-1313
Mailing Address
Mr. BRAD A MANGUM P.T.
1055 N 500 W ATTN: CREDENTIALING
PROVO, UT 84604
Phone number: 801-354-8225
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