Individual
DR. NICHOLAS ALAN MANTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W BROADWAY ST STE 320, MISSOULA, MT 59802-4003
(406) 329-5615
(406) 329-5606
Mailing address
PO BOX 31001, PASADENA, CA 91110-4114
(406) 329-5615
(406) 329-5606
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
MED-PHYS-LIC-86861
MT
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MED-PHYS-LIC-86861
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2009
Last updated
01/15/2026
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