Individual
SADIE ALANE MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA/L
Contact information
Practice address
3131 WESTERN AVE, KINGMAN, AZ 86401-0951
(928) 718-0718
Mailing address
1933 WINDSOR AVE, OWENSBORO, KY 42301-4454
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A03508
KY
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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