Individual
MRS. CHRISTINE MARIE MANTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14 JONES HOLLOW RD, MARLBOROUGH, CT 06447-1448
(860) 295-8217
(860) 295-9734
Mailing address
319 OLDE STAGE RD, GLASTONBURY, CT 06033-3215
(413) 822-9863
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001208
CT
Other
Enumeration date
08/09/2006
Last updated
03/12/2009
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