Herchel Mangune, PTA

NPI #1467272294 in Great Lakes, Illinois

Provider Information

NPI Number: 1467272294
Entity Type: Individual
Name: Herchel Mangune, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Oct 16, 2024
Last Updated: Mar 19, 2025

Practice Location

Address: 3410 ILLINOIS ST
City: Great Lakes
State: Illinois
ZIP Code: 60088-3120
Phone: (224) 610-8553

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Medicine & Rehabilitation	208100000X
Physical Therapy Assistant	225200000X	Primary

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