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Individual

DR. GREGG A. MANTONYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
919 N 21ST ST, NEWARK, OH 43055-2919
(740) 366-6601
(740) 366-6286
Mailing address
919 N 21ST ST, NEWARK, OH 43055-2919
(740) 366-6601
(740) 366-6286

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3023
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000211465
ANTHEM BC/BS
OH
05
2190016
OH
01
310811048031
CARESOURCE
OH
01
350050808
PALMETTO GBA RR MEDICARE
OH
Enumeration date
02/10/2006
Last updated
09/25/2007
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