Individual
MR. MATTHEW B DEWILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, LMT
Contact information
Practice address
1020 LINCOLN RD, BETTENDORF, IA 52722-4141
(563) 484-0550
Mailing address
736 FEDERAL ST APT 1205, DAVENPORT, IA 52803-5751
(563) 940-1299
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
090478
IA
163WI0500X
Infusion Therapy Registered Nurse
Primary
090478
IA
163WX0106X
Occupational Health Registered Nurse
090478
IA
225700000X
Massage Therapist
006683
IA
Other
Enumeration date
02/27/2011
Last updated
04/12/2022
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