Individual
PHILLIP LEE MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1416 W 4TH ST, WATERLOO, IA 50702-2908
(319) 232-7113
(319) 232-6843
Mailing address
1416 W 4TH ST, WATERLOO, IA 50702-2908
(319) 232-7113
(319) 232-6843
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
079082
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417145640
—
IA
Enumeration date
01/29/2022
Last updated
01/29/2022
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