Individual
SCOTT G MATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(844) 458-2100
Mailing address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(844) 458-2100
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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