# CHARLES D. MANTER DO PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Medical Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457531808
- **Authorized official:** DR. CHARLES DAVID MANTER DO (OWNER)
- **Authorized official phone:** (970) 352-3274

## Contact information

- **Practice address:** 2918 W 10TH ST, GREELEY, CO 80634-5457
- **Practice address phone:** (970) 352-3274
- **Practice address fax:** (970) 352-3279
- **Mailing address:** 2918 W 10TH ST, GREELEY, CO 80634-5457
- **Mailing address phone:** (970) 352-3274
- **Mailing address fax:** (970) 352-3279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 30988 | CO | Yes |

## Other

- **Enumeration date:** 11/13/2007
- **Last updated:** 09/25/2013