Individual
DR. HOLLY M MANTOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-2855
(423) 844-2897
Mailing address
420 WOODWAY DR, BLOUNTVILLE, TN 37617-5558
(423) 323-3047
(423) 844-2897
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9074
TN
Other
Enumeration date
01/17/2011
Last updated
01/17/2011
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