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Individual

LAUREN COLBY MANGUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LAT, ATC

Contact information

Practice address
4364 SCORPIUS STREET HS2 ROOM 235, ORLANDO, FL 32816-2455
(407) 823-2795
Mailing address
4364 SCORPIUS STREET HS2 ROOM 235, ORLANDO, FL 32816-0001
(407) 823-2795

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1168
SC
2255A2300X
Athletic Trainer
Primary
AL5447
FL

Other

Enumeration date
05/15/2012
Last updated
01/26/2023
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