Individual
JONATHAN MANTOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T
Contact information
Practice address
41 PARK CREEK DR, GREENVILLE, SC 29605-4270
(864) 299-1600
Mailing address
205 HUNTINGTON DR, LIBERTY, SC 29657-8935
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7862
SC
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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