Individual
MS. LORA A MANGIAFICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2940 E BANNER GATEWAY DR, SUITE 200, GILBERT, AZ 85234-2168
(480) 964-2908
(480) 833-2136
Mailing address
PO BOX 271429, SALT LAKE CITY, UT 84127-1429
(602) 772-3800
(602) 772-3801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6062
AZ
363AS0400X
Surgical Physician Assistant
AP2630
MA
Other
Enumeration date
10/16/2008
Last updated
11/21/2016
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