Individual
MRS. CHARLENE MARJORIE MANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5139 US HIGHWAY 19, NEW PT RICHEY, FL 34652-3966
(727) 849-6076
Mailing address
5139 US HIGHWAY 19, NEW PT RICHEY, FL 34652-3966
(727) 849-6076
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS2621
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
610268900
—
FL
Enumeration date
07/10/2007
Last updated
05/21/2008
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