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1518019876
CRYSTAL GAIL MANGRUM
KINGSTON SPRINGS, TN
NPI
1518019876
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183700000X Pharmacy Technician
(Licence: TN 14104)
Enumeration Date
2007-01-17
Last Update Date
2007-07-08
Business Address
CRYSTAL GAIL MANGRUM C.PH.T
111 W. KINGSTON SPRINGS RD STE 103
KINGSTON SPRINGS, TN 37082
Phone number: 615-952-3690
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Mailing Address
CRYSTAL GAIL MANGRUM C.PH.T
PO BOX 420
BON AQUA, TN 37025-0420
Phone number: 615-412-3001
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