Organization
MOGU 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATOYSHA SHANTA DANGLER (LAB BILLING MANAGER)
(404) 943-0205
Entity
Organization
Contact information
Practice address
816 S KIRKWOOD RD STE 100, KIRKWOOD, MO 63122-6056
(314) 686-4990
(314) 686-4999
Mailing address
5909 PEACHTREE DUNWOODY RD, ATLANTA, GA 30328-8102
(404) 943-0205
(404) 943-0209
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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