Individual
MATTHEW ALEXANDER MORISETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1060 GAFFNEY RD. #7440, USA MEDDAC-AK / ATTN: MCUC-MMD-QM (CREDENTIALS), FT. WAINWRIGHT, AK 99703-7440
(907) 361-5603
Mailing address
2 LAZY W RD, FOUNTAIN, CO 80817-3315
(253) 306-9054
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1127047
CO
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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