Individual
JORDAN MARIE MANTELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
509 W 18TH ST, HERMANN, MO 65041-1547
(573) 486-2154
Mailing address
820 HILLCREST DR, OWENSVILLE, MO 65066-2823
(573) 301-2278
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2014037305
MO
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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