Individual
LARRY L MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2233 PARK AVENUE, STE 303, ORANGE PARK, FL 32073
(904) 264-6800
(904) 264-7066
Mailing address
2233 PARK AVENUE, STE 303, ORANGE PARK, FL 32073
(904) 264-6800
(904) 264-7066
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
OS5284
FL
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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