Individual
MR. MATTHEW PRESTON RAINBOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3619 DESERT ROSE LN, LAKE HAVASU CITY, AZ 86404-1748
(337) 349-6708
Mailing address
PO BOX 51131, LAFAYETTE, LA 70505-1131
(337) 349-6708
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05706
NC
363A00000X
Physician Assistant
6039
AZ
Other
Enumeration date
04/12/2015
Last updated
11/15/2022
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