J Mandava LLC
NPI #1811083892 in Saint Peters, Missouri
Provider Information
- NPI Number
- 1811083892
- Entity Type
- Organization
- Organization Name
- J Mandava LLC
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Oct 5, 2006
- Last Updated
- Jun 18, 2008
Practice Location
- Address
- 255 SPENCER RD
- Address 2
- SUITE 201
- City
- Saint Peters
- State
- Missouri
- ZIP Code
- 63376-2494
- Phone
- (636) 939-2550
Authorized Official
- Name
- JYOTHI MANDAVA, MD
- Title
- OWNER
- Phone
- (636) 939-2550
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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