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Individual

AUSTIN BANGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
511 8TH ST, CLARKSVILLE, TN 37040-3093
(931) 920-7200
Mailing address
2191 MEMORIAL DR APT B16, CLARKSVILLE, TN 37043-4407
(980) 925-9363

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/21/2021
Last updated
05/21/2021
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