Individual
GARY E MENTZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
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
07/13/2026
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