Individual
MR. AARON MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, ATC
Contact information
Practice address
2850 JERICHO ROAD, LAGRANGE, KY 40031
(502) 648-8483
Mailing address
2850 JERICHO RD, LA GRANGE, KY 40031-8215
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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