PAYTON MANGHAM

SHREVEPORT, LA
NPI1376231837
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-04-24
Last Update Date2023-04-24
Business Address
PAYTON MANGHAM
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-2445
Mailing Address
PAYTON MANGHAM
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: