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Individual

DR. GARY MARC MANTELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
5180 PARK AVE STE 220, MEMPHIS, TN 38119-3530
(901) 682-4668
(901) 683-2963
Mailing address
5180 PARK AVE STE 220, MEMPHIS, TN 38119-3530
(901) 682-4668
(901) 683-2963

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
DPM283
TN
213ES0131X
Foot Surgery Podiatrist
DPM283
TN

Other

Enumeration date
07/26/2006
Last updated
11/21/2007
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