Provider Demographics
NPI:1043800113
Name:MENTZ, JUSTICE B
Entity Type:Individual
Prefix:
First Name:JUSTICE
Middle Name:B
Last Name:MENTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1200
Mailing Address - Country:US
Mailing Address - Phone:720-840-3728
Mailing Address - Fax:
Practice Address - Street 1:7520 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-1200
Practice Address - Country:US
Practice Address - Phone:720-840-3728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula