Individual
MR. JAIRUS-JOAQUIN R MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2927 SMITH RIDGE TRCE, NORCROSS, GA 30071-2643
(678) 458-0607
Mailing address
2927 SMITH RIDGE TRCE, NORCROSS, GA 30071-2643
(678) 458-0607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
006746
GA
235Z00000X
Speech-Language Pathologist
16975
CA
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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