Individual
DENNIS MANSAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
116 1ST ST E, JAMESTOWN, ND 58401-4253
(701) 952-6850
(701) 252-1561
Mailing address
PO BOX 809, JAMESTOWN, ND 58402-0809
(701) 952-6819
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50757
—
ND
Enumeration date
05/17/2018
Last updated
05/17/2018
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