Individual
MS. MARY E MANGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3102 CHESTERFIELD AVE, CHARLESTON, WV 25304-1214
(304) 346-6688
(304) 346-6688
Mailing address
3102 CHESTERFIELD AVE, CHARLESTON, WV 25304-1214
(304) 346-6688
(304) 346-6688
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
563
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7600091
—
WV
Enumeration date
04/13/2006
Last updated
08/18/2010
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