Individual
MR. JONATHAN HUGH MANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
220 E. ROGERS RD, LONGMONT, CO 80501
(303) 776-3250
Mailing address
935 BUNGALOW CT, FORT COLLINS, CO 80521
(646) 678-1174
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2892
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81686048
—
CO
Enumeration date
01/08/2009
Last updated
10/22/2013
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