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General NPI Number Information
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NPI Number | 1588522619
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Entity Type | Individual
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Provider Name | JUSTINE MANTZ
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Gender | Female
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 190 PROSPERITY DR STE 4
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City | WINCHESTER
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State | VA
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Zip | 22602-5401
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Country | US
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Telephone | 540-247-8702
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Fax |
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Provider Business Mailing Address
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Address Line | 1087 COLD STREAM ROAD
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City | CAPON BRIDGE
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State | WV
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Zip | 26711
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Country | US
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Telephone | 540-532-8123
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146E00000X
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Taxonomy Name | Community Paramedic
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License Number | 1355
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License Number State | WV
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