Individual
JOHN F. MANGIALARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7065 AIRWAYS BLVD STE 110, SOUTHAVEN, MS 38671-5874
(662) 349-8997
(662) 349-8987
Mailing address
7065 AIRWAYS BLVD STE 110, SOUTHAVEN, MS 38671-5874
(662) 349-8997
(662) 349-8987
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6169
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT6169
PT LICENSE
MS
Enumeration date
06/29/2017
Last updated
06/29/2017
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