Individual
VICKIE LYNN MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1018 MILES AVE SE, BEMIDJI, MN 56601
(218) 209-5288
Mailing address
519 3RD ST NW, BEMIDJI, MN 56601
(763) 267-8771
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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