Jeremy Peter Mang

NPI #1881290740 in Gasport, New York

Provider Information

NPI Number: 1881290740
Entity Type: Individual
Name: Jeremy Peter Mang
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Dec 7, 2020
Last Updated: Dec 7, 2020

Practice Location

Address: 4540 LINCOLN DR
City: Gasport
State: New York
ZIP Code: 14067-9212
Phone: (716) 772-2631

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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