Individual
MRS. BRANDI NICHOLE MANGRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1776 DECLARATION WAY, THOMPSONS STATION, TN 37179-9674
(615) 417-9656
Mailing address
2707 PALACE CT, THOMPSONS STATION, TN 37179-9290
(615) 927-7032
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
812
TN
Other
Enumeration date
03/09/2007
Last updated
01/01/2018
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