Individual
ALLISON MANGRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
50 N MEDICAL DR # 1R107, SALT LAKE CITY, UT 84132-0001
(801) 581-2619
(801) 581-2525
Mailing address
10328 S 2260 E, SANDY, UT 84092-4401
(801) 865-5645
(801) 733-4334
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
54864492401
UT
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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