Individual
JERRY MATHENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12814 SHANK FARM WAY, HAGERSTOWN, MD 21742-2948
(240) 513-6981
Mailing address
12814 SHANK FARM WAY, HAGERSTOWN, MD 21742-2948
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/17/2019
Last updated
11/17/2019
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