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1194117671
DEANNA MARIE MANTLE
JEFFERSON CITY, MO
NPI
1194117671
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 2008020776)
Enumeration Date
2015-02-20
Last Update Date
2015-02-20
Business Address
Mrs. DEANNA MARIE MANTLE
1125 MADISON ST
JEFFERSON CITY, MO 65101-5227
Phone number: 573-632-5581
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Mailing Address
Mrs. DEANNA MARIE MANTLE
1716 HIGHWAY C
BONNOTS MILL, MO 65016-2104
Phone number:
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