Individual
BRAEDEN ALLEN MANTONYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-3333
Mailing address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-3333
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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