Individual
BETH W. MANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
29544 SE HEIPLE RD, EAGLE CREEK, OR 97022-9664
(503) 887-6070
(503) 630-2860
Mailing address
29544 SE HEIPLE RD, EAGLE CREEK, OR 97022-9664
(503) 887-6070
(503) 630-2860
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
18018
OR
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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