Individual
DR. JERED MARC MANCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
Mailing address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
5101018298
MI
207YS0123X
Facial Plastic Surgery Physician
Primary
9230
SD
Other
Enumeration date
06/15/2009
Last updated
07/16/2014
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