Individual
SAMUEL YEL MANGONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4220 ERSKINE ST, OMAHA, NE 68111-3419
(531) 389-9150
Mailing address
4220 ERSKINE ST, OMAHA, NE 68111-3419
(531) 389-9150
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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