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MS. JYL A MANGOONI MBA, ATC, LAT

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1295885242

Individual Registrant:
MS. JYL A MANGOONI MBA, ATC, LAT
Gender: F
Sole Proprietor

Location and contact information for practice:
1201 N SCENIC HWY  BABSON PARK, FL 33827-9751 US
Tel: 863-638-2949  Fax: --

Contact information for business:
1071 CASCADE CIR  ROCKLEDGE, FL 32955-8083 US
Tel: 321-961-5593  Fax: --

Registration Information:
NPI: 1295885242
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
FLAL 1832

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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