Individual
MATTHEW VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3207 HILLCREST DR, SCOTTSBORO, AL 35769-6421
(256) 609-4300
Mailing address
3207 HILLCREST DR, SCOTTSBORO, AL 35769-6421
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12747
AL
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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