Individual
ANTHONY MATTIODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 N 1ST ST, HERMISTON, OR 97838-1102
(541) 567-5323
Mailing address
26350 HORSELL RD, BEND, OR 97701-9688
(541) 306-0683
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0017683
OR
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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