Individual
DR. CHARLES DAVID MANTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2918 W 10TH ST, GREELEY, CO 80634-5472
(970) 352-3274
(970) 352-3279
Mailing address
2918 W 10TH ST, GREELEY, CO 80634-5457
(970) 352-3274
(970) 352-3279
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30988
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01309889
—
CO
Enumeration date
10/06/2006
Last updated
03/24/2021
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