KEVIN DEE MANGUM

METAIRIE, LA
NPI1417174392
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA  ATH.J00034)
Enumeration Date2007-04-20
Last Update Date2007-07-08
Business Address
Mr. KEVIN DEE MANGUM ATC LAT
5800 AIRLINE DR
METAIRIE, LA 70003-3876
Phone number: 504-733-0255
Mailing Address
Mr. KEVIN DEE MANGUM ATC LAT
5325 COCOS PLUMOSAS DR
KENNER, LA 70065-2320
Phone number: 504-885-9111