Individual
MARK THOMAS MENTZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2200 BLAIRSFERRY CROSSING, HIAWATHA, IA 52233-7900
(319) 294-9546
(319) 395-0089
Mailing address
2200 BLAIRSFERRY CROSSING, HIAWATHA, IA 52233-7900
(319) 294-9546
(319) 395-0089
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01912
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3284331
—
IA
Enumeration date
10/24/2007
Last updated
06/15/2009
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