Individual
RONALD MANGELSDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSB
Contact information
Practice address
12189 E FENCE LINE DR, PALMER, AK 99645-8119
(907) 746-3236
Mailing address
PO BOX 4426, PALMER, AK 99645-4426
(907) 746-3236
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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