Individual
ANNY JOHANNA MANTILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
198 THOMAS JOHNSON DR STE 8, FREDERICK, MD 21702-4442
(301) 732-3304
(301) 228-3904
Mailing address
198 THOMAS JOHNSON DR STE 8, FREDERICK, MD 21702-4442
(301) 732-3304
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M06203
MD
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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