Individual
JESSICA MANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(603) 667-7678
Mailing address
34 SCHAEFER CIR, HUDSON, NH 03051-5405
(603) 689-3923
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA5179
MA
Other
Enumeration date
10/14/2014
Last updated
10/08/2019
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