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NPI Code Detail

MEDICARE: LAURA MANGARELLI-KALLENBERG P.T.

MEDICARE: LAURA MANGARELLI-KALLENBERG P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1137727TX
22251X0800XOrthopedic Physical Therapist1137727TX

General Provider Information

NPI Number : 1780878652
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA MANGARELLI-KALLENBERG P.T.
Provider Business Mailing Address
First Line : 1139 SPANISH MOSS DR
Second Line :
City : SAVANNAH
State : TX
Zip : 76227-7781
Country : US
Telephone Number : 972-347-1586
Fax Number :
Provider Business Practice Location Address
First Line : 2535 W OAK ST
Second Line :
City : DENTON
State : TX
Zip : 76201-2331
Country : US
Telephone Number : 940-382-2649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2007
Last Update Date : 05/30/2013

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Directions to “ LAURA MANGARELLI-KALLENBERG P.T.” Practice Location

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