Individual
MR. JACK M MANTIONE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Contact information
Practice address
112 E 61ST ST, NEW YORK, NY 10065-8514
(212) 867-1777
(212) 371-2079
Mailing address
112 E 61ST ST, NEW YORK, NY 10065-8514
(212) 867-1777
(212) 371-2079
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
023347-1
NY
Other
Enumeration date
04/23/2008
Last updated
01/24/2009
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