Individual
STEPHANIE ELAINE FANGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
709 W MAIN ST STE 3, MANCHESTER, IA 52057-1526
(563) 927-7698
(269) 349-2898
Mailing address
709 W MAIN ST STE 3, MANCHESTER, IA 52057-1526
(563) 927-7777
(269) 226-7911
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601006398
MI
Other
Enumeration date
07/18/2012
Last updated
10/28/2020
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