Individual
MARIE MANTELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
377 PLANTATION ST, WORCESTER, MA 01605-2245
(413) 584-4040
(508) 793-7858
Mailing address
377 PLANTATION ST, WORCESTER, MA 01605-2245
(413) 584-4040
(508) 793-7858
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT978
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932284171
—
ME
Enumeration date
08/09/2016
Last updated
10/04/2023
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