Individual
JILLIAN MANTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 24TH AVE S, NASHVILLE, TN 37212-2637
(615) 327-4751
Mailing address
104 CUVEE CT, WHITE HOUSE, TN 37188-9588
(615) 239-9346
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
230777
TN
Other
Enumeration date
11/22/2023
Last updated
11/22/2023
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