Provider Demographics
NPI:1740499458
Name:MANGAN, PATRICIA MARIE (PT, MS)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARIE
Last Name:MANGAN
Suffix:
Gender:F
Credentials:PT, MS
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Mailing Address - Street 1:3055 N RESERVE ST STE D
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1395
Mailing Address - Country:US
Mailing Address - Phone:406-327-1827
Mailing Address - Fax:406-327-1697
Practice Address - Street 1:3055 N RESERVE ST STE D
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808
Practice Address - Country:US
Practice Address - Phone:406-327-1827
Practice Address - Fax:406-327-1697
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2019-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT525PT2251X0800X
MT5252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic