Individual
GARY E MENTZEL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2100 NORTH KIMBALL, MITCHELL, SD 57301
(605) 996-8712
(605) 996-7513
Mailing address
2100 NORTH KIMBALL, MITCHELL, SD 57301
(605) 996-8712
(605) 996-7513
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
989
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4994547
BXBS OF SD
—
05
—
5832794
—
SD
Enumeration date
03/14/2006
Last updated
07/08/2007
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