Admin Client || Dee Karawadra

Created On May, 09 2023 11:00am ID #299 Back

Merchant (Business) DBA Name : Gary M Mantell DPM

Business Legal Name : Gary M Mantell DPM

Contact Name : Gary Mantell

Contact Phone Number : 901-682-4668

Physical Address : 5180 Park Ave #200

City : MEMPHIS

State : TN

Country : USA

Zip : 38119

Email Address : [email protected]

<?xml version="1.0"?>
<object>
  <sales_number>12232233</sales_number>
  <sales_office/>
  <sales_signing_rep/>
  <irs_tax_id_type/>
  <irs_tax_id_no/>
  <ownership_type/>
  <business_incorporated/>
  <business_description/>
  <mailing_address>5180 Park Ave #200</mailing_address>
  <mailing_city>MEMPHIS</mailing_city>
  <mailing_state>TN</mailing_state>
  <mailing_zip>38119</mailing_zip>
  <business_phone>901-682-4668</business_phone>
  <contact_first_name>Gary</contact_first_name>
  <contact_last_name>Mantell</contact_last_name>
  <contact_phone>901-682-4668</contact_phone>
  <location_address>5180 Park Ave #200</location_address>
  <location_city>MEMPHIS</location_city>
  <location_state>TN</location_state>
  <location_zip>38119</location_zip>
  <avg_ticket_amount/>
  <ave_month_volume/>
  <bank_name/>
  <bank_transit_number/>
  <bank_dda_no/>
  <gross_vs_net/>
  <refund_policy>0</refund_policy>
  <owner1_first_name>Gary</owner1_first_name>
  <owner1_last_name>Mantell</owner1_last_name>
  <owner1_home_address>6317 Common Oaks Ct Apt 102</owner1_home_address>
  <owner1_home_city>Memphis</owner1_home_city>
  <owner1_home_state>TN</owner1_home_state>
  <owner1_home_zip>38120</owner1_home_zip>
  <owner1_home_phone>9014841987</owner1_home_phone>
  <owner1_title>owner</owner1_title>
  <owner1_ownership_perc/>
  <owner1_dob>1952-03-23</owner1_dob>
  <owner1_social_securrity_no>139402672</owner1_social_securrity_no>
  <owner1_form_of_id>Drivers License</owner1_form_of_id>
  <owner1_number>067398203</owner1_number>
  <owner1_expired>2025-04-23</owner1_expired>
  <owner1_issuer_state>TN</owner1_issuer_state>
  <owner1_issued_date>2019-04-23</owner1_issued_date>
</object>

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