Individual
JACK MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3707 N WOODLAWN BLVD, WICHITA, KS 67220-2222
(316) 691-9134
(316) 691-9138
Mailing address
3707 N WOODLAWN BLVD, WICHITA, KS 67220-2222
(316) 691-9134
(316) 691-9138
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11225
KS
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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