Jordan Marie Mantels
Individual provider Active NPI Physical Therapy Assistant · Hermann, MO
NPI 1649934324 · NPPES record last updated Oct 28, 2021
Key facts
- NPI
- 1649934324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2014037305 (MO)
- Practice address
- 509 W 18TH St
Hermann, MO 65041-1547 - Phone
- (573) 486-2154
- NPI assigned
- Oct 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014037305 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2014037305 | MO | Yes |
Addresses
Primary practice location
509 W 18TH St
Hermann, MO 65041-1547
Mailing address
820 Hillcrest Dr
Owensville, MO 65066-2823
Phone (573) 301-2278
Other practice location 1
1016 W Highway 28
Owensville, MO 65066-1677
Phone (573) 437-6877
Other providers in Hermann, MO
- Kelsey A Kessler
- Shari Lyn Kicker
- Jaime K Koenigsfeld
- Lloyd Healthcare Management Systems Inc
- Michael W Mahoney
- Holly Marek
- Chad Aaron May
- Douglas Harold Meyer
- Franklin Edward Meyer
- Orthopedic Specialists, PC
All providers in Hermann, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.