Individual
DR. RYAN DUANE MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1700 E BOGARD RD BLDG B, WASILLA, AK 99654-6563
(907) 357-4111
(907) 357-4199
Mailing address
PO BOX 874992, WASILLA, AK 99687-4992
(907) 357-4111
(907) 357-4199
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
360
AK
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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