Individual
DR. CARL G MATTACOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
AT 400
KY
246Z00000X
Other Specialist/Technologist
Primary
AT400
KY
Other
Enumeration date
02/07/2006
Last updated
07/13/2026
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