Organization
CENTER FOR MINIMALLY INVASIVE SPINECARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JAMES MANGO M.D. (OWNER)
(574) 850-8408
Entity
Organization
Contact information
Practice address
270 E DAY RD, SUITE #200, MISHAWAKA, IN 46545-3444
(574) 850-8408
Mailing address
50960 FOX TRL, GRANGER, IN 46530-9039
(574) 850-8408
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
01065998A
IN
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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