Jason K Manthei, PA
Physician Assistant in Gillespie, IL. Individual provider (NPI-1).
NPI number1477586121
StatusActive
Last updated in NPPESApr 10, 2008
Details
- NPI
- 1477586121
- Entity type
- Individual (NPI-1)
- Name
- Jason K Manthei
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2006
- Last updated
- Apr 10, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085002364 | IL | Yes |
Practice location
715 Broadway StGillespie, IL 62033-1166
Phone 217-839-4491
Mailing address
715 Broadway StGillespie, IL 62033-1166
Phone 217-839-4491
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