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Individual

MR. MARIO JOHN MENTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
8055 W BELL ROAD, T-0825, PEORIA, AZ 85382
(623) 979-4484
Mailing address
8055 W BELL ROAD, PEORIA, AZ 85382
(623) 979-4484

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
RP039095L
PA
183500000X
Pharmacist
Primary
S011346
AZ

Other

Enumeration date
10/05/2011
Last updated
10/05/2011
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