Individual
AMY MANGRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 MEDICAL CENTER DR, COLUMBIA, TN 38401-6402
(188) 829-1435
Mailing address
1222 MEDICAL CENTER DR, COLUMBIA, TN 38401-6402
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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