Individual
DR. JARED D MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, MBA, LMT
Contact information
Practice address
8659 N RUDE ST, HAYDEN, ID 83835-8255
(801) 762-7447
Mailing address
8659 N RUDE ST, HAYDEN, ID 83835-8255
(801) 762-7447
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
5266084-1202
UT
111N00000X
Chiropractor
Primary
CHIA-2025
ID
Other
Enumeration date
04/18/2012
Last updated
07/06/2020
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