RYAN DAVID MANTOOTH

FAYETTEVILLE, AR
NPI1114450822
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: AR  E-13154)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: AL  MD.37708)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-04-10
Last Update Date2021-04-09
Business Address
RYAN DAVID MANTOOTH MD
3215 N NORTH HILLS BLVD.
FAYETTEVILLE, AR 72703
Phone number: 479-463-7102
Mailing Address
RYAN DAVID MANTOOTH MD
PO BOX 550
LOWELL, AR 72745-1900
Phone number: 479-473-7775