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Individual

JASON K MANTHEI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
715 BROADWAY ST, GILLESPIE, IL 62033-1166
(217) 839-4491
Mailing address
715 BROADWAY ST, GILLESPIE, IL 62033-1166
(217) 839-4491

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
IL

Other

Enumeration date
07/08/2006
Last updated
04/10/2008
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