person
Ethan Rafael Mangum
Student in an Organized Health Care Education/Training Program in Layton, Utah
NPI 1134979495

Ethan Rafael Mangum is a Student in an Organized Health Care Education/Training Program based in Layton, UT. Ethan Rafael Mangum practices in Layton, UT. The NPI Number for Ethan Rafael Mangum is 1134979495 and holds a License No. (Utah).

The current practice location address for Ethan Rafael Mangum is 1172 W Seraphim Ct, Layton, UT and can be reached out via phone at 385-439-3790.

Location: 1172 W Seraphim Ct, Layton, UT, 84041-2213
person
Provider Profile Details
NPI Number
1134979495
Provider Name
Ethan Rafael Mangum
Credential
Provider Entity Type
Individual
Gender
Male
Address
1172 W Seraphim Ct, Layton, UT, 84041-2213
Phone Number
385-439-3790
Fax Number
Provider Enumeration Date
03/26/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
1172 W Seraphim Ct
City
State
Zip
84041-2213
Phone Number
385-439-3790
Fax Number
person
Provider Business Mailing Address Details
Address
1172 W Seraphim Ct
City
State
Zip
84041-2213
Phone Number
385-439-3790
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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