Individual
DANIEL MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1912 HAYES AVE, SANDUSKY, OH 44870-4736
(419) 609-1460
Mailing address
1912 HAYES AVE, SANDUSKY, OH 44870-4736
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
127797
OH
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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