Individual
MATTHEW KOELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1015 LANTON RD, WEST PLAINS, MO 65775-3854
(417) 256-2570
Mailing address
1015 LANTON RD, WEST PLAINS, MO 65775-3854
(417) 256-2570
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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