Individual
MARK MANGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9 TWAITS RD, TOWACO, NJ 07082-1223
(973) 334-1357
Mailing address
9 TWAITS RD, TOWACO, NJ 07082-1223
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00304200
NJ
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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