Individual
MR. MARK R MENCEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
416 FRONTAGE RD STE 400, KENAI, AK 99611-7770
(877) 522-1275
(833) 888-7145
Mailing address
220 SOUTH 16TH AVE, UNIT B, BOZEMAN, MT 59715
(406) 381-3308
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-27456
MT
363AM0700X
Medical Physician Assistant
PA2012-0061
NM
Other
Enumeration date
10/29/2010
Last updated
11/18/2024
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