Individual
TIM ANGELO DI MANGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, ATC, LAT
Contact information
Practice address
4000 WHITING DR, MIDLAND, MI 48640-2398
(248) 760-3028
Mailing address
4512 N SAGINAW RD APT 207, MIDLAND, MI 48640-2004
(248) 760-3028
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002636
MI
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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