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Individual
NITIN MANTENA
Active
Individual
NITIN MANTENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60291255
WA
183500000X
Pharmacist
RPH0013198
OR
Other
Enumeration date
11/09/2012
Last updated
07/22/2025
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