Individual
MICHAEL SCOTT MATTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335-4219
(951) 643-2340
Mailing address
9075 FOOTHILL BLVD APT G24, RANCHO CUCAMONGA, CA 91730-3464
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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