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Individual

PETER DOUGLAS MANTELL III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
130 MILLERS FALLS RD, TURNERS FALLS, MA 01376-2250
(413) 835-1564
Mailing address
130 MILLERS FALLS RD, TURNERS FALLS, MA 01376-2250
(413) 835-1564

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
175T00000X
CLINICAL AND SUPPORT OPTIONS
MA
Enumeration date
02/13/2020
Last updated
02/13/2020
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  • EDI platform