Individual
DAVID E. MANGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
20 FOUR MILE DR STE 2, KALISPELL, MT 59901-2644
(406) 300-4882
(406) 257-2706
Mailing address
20 FOUR MILE DR STE 2, KALISPELL, MT 59901-2644
(406) 300-4882
(406) 257-2706
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
323
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000094853
BC/BS
MT
05
—
4302139
—
MT
Enumeration date
08/31/2006
Last updated
10/17/2024
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