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1962018077
REGINALD MUNGRUE
LAKELAND, FL
NPI
1962018077
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL al3036)
Enumeration Date
2020-09-23
Last Update Date
2020-09-23
Business Address
REGINALD MUNGRUE
111 LAKE HOLLINGSWORTH DR
LAKELAND, FL 33801-5698
Phone number: 863-680-4267
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Mailing Address
REGINALD MUNGRUE
7357 GUNSTOCK DR
LAKELAND, FL 33809-6616
Phone number: 863-712-0261
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