Individual
DELORES GENEVIEVE MATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMT
Contact information
Practice address
200 5TH ST NW, SUITE D, ELK RIVER, MN 55330-1917
(763) 300-1022
(763) 633-7827
Mailing address
200 5TH ST NW, SUITE D, ELK RIVER, MN 55330-1917
(763) 300-1022
(763) 633-7827
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT 08 - 50
MN
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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