Individual
BROOKE NELSON-MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
872 SINGLETON RIDGE RD, CONWAY, SC 29526-1101
(843) 347-3050
(843) 347-0533
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(610) 991-2034
(610) 438-2046
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3135
SC
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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