Individual
REGINALD MUNGRUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 LAKE HOLLINGSWORTH DR, LAKELAND, FL 33801-5698
(863) 680-4267
Mailing address
7357 GUNSTOCK DR, LAKELAND, FL 33809-6616
(863) 712-0261
(863) 680-4122
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3036
FL
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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