Organization
MAT PRAC GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL DAWSON (COO)
(502) 681-5752
Entity
Organization
Contact information
Practice address
204 S FLOYD ST, BOX 8, LOUISVILLE, KY 40202-1208
(502) 681-5752
Mailing address
204 S FLOYD ST, BOX 8, LOUISVILLE, KY 40202-1208
(502) 681-5752
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
05/20/2015
Last updated
07/02/2015
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