James R Mangerson, PA-C

NPI #1093078446 in Peoria, Illinois

Provider Information

NPI Number: 1093078446
Entity Type: Individual
Name: James R Mangerson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jun 20, 2012
Last Updated: Jan 27, 2025

Practice Location

Address: 515 NE GLEN OAK AVE STE 202
City: Peoria
State: Illinois
ZIP Code: 61603-3166
Phone: (309) 624-4455

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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