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1376231837
PAYTON MANGHAM
SHREVEPORT, LA
NPI
1376231837
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-24
Last Update Date
2023-04-24
Business Address
PAYTON MANGHAM
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-2445
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Mailing Address
PAYTON MANGHAM
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number:
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