Most Relevant Information
Provider Data
| NPI Number: | 1003463340 |
| Provider Name: | MARCIA MAE MENTELE |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/21/2019 |
| Last Updated: | 08/21/2019 |
Provider Practice Location
4627 W HOMEFIELD DR
SIOUX FALLS
SD
571063511
Practice Location Phone/Fax
| Phone: | 6053362010 |
| Fax: | 6053360249 |
Provider Mailing Location
4627 W HOMEFIELD DR
SIOUX FALLS
SD
571063511
Provider Mailing Phone/Fax
| Phone: | 6053362010 |
| Fax: | 6053360249 |