Derek Mantlo
NPI #1962825182 in High Springs, Florida
Provider Information
- NPI Number
- 1962825182
- Entity Type
- Individual
- Name
- Derek Mantlo
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Contractor
- Enumeration Date
- Jan 23, 2014
- Last Updated
- Feb 10, 2014
Practice Location
- Address
- 20688 NW 252ND ST
- City
- High Springs
- State
- Florida
- ZIP Code
- 32643-8419
- Phone
- (352) 275-1652
Specialties & Taxonomy Codes
| Specialty |
|---|
| Contractor |
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