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Individual

MRS. JULIE MANGRUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2255 CANDIES LN NW, CLEVELAND, TN 37312-2661
(423) 472-4700
Mailing address
1302 BLOCKER LN, EAST RIDGE, TN 37412-1458
(423) 368-4752

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5469
TN

Other

Enumeration date
11/01/2022
Last updated
11/01/2022
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