Individual
MR. MATTHEW SCOTT MAZARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
10470 DIBERVILLE BLVD, DIBERVILLE, MS 39540-2419
(228) 280-8120
(228) 280-8121
Mailing address
10470 DIBERVILLE BLVD, DIBERVILLE, MS 39540-2419
(228) 280-8120
(228) 280-8121
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5837
MS
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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