Individual
MIKE L MANGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
428 W GRAND AVE, CHICKASHA, OK 73018-5865
(405) 222-5555
(405) 222-2028
Mailing address
428 W GRAND AVE, CHICKASHA, OK 73018-5865
(405) 222-5555
(405) 222-2028
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
679
OK
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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