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Individual

MR. KEVIN CHARLES MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LO

Contact information

Practice address
12315 JUDSON RD, #206, LIVE OAK, TX 78233-3277
(210) 657-8100
(210) 657-8105
Mailing address
12315 JUDSON RD, #206, LIVE OAK, TX 78233-3277
(210) 657-8100
(210) 657-8105

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
558
TX

Other

Enumeration date
11/14/2006
Last updated
12/31/2007
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