Individual
JODY KAYE MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPA-C
Contact information
Practice address
1107 REYNOLDS ST, MONROE, NC 28112-4351
(704) 289-8220
(704) 289-9195
Mailing address
1107 REYNOLDS ST, MONROE, NC 28112-4351
(704) 289-8220
(704) 289-9195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103793
NC
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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