Individual
ROBERT JAMES MAMANGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5980 W 71ST ST, SUITE 201, INDIANAPOLIS, IN 46278-2711
(317) 388-0800
(317) 388-0805
Mailing address
5980 W 71ST ST, SUITE 201, INDIANAPOLIS, IN 46278-2711
(317) 388-0800
(317) 388-0805
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
40QA01234600
NJ
225100000X
Physical Therapist
Primary
36714
CA
Other
Enumeration date
03/16/2007
Last updated
12/12/2018
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