Individual
KEVIN MATKAITI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5815 NORELL AVE N, OAK PARK HEIGHTS, MN 55082-1766
(651) 439-7630
Mailing address
5815 NORELL AVE N, OAK PARK HEIGHTS, MN 55082-1766
(651) 430-7630
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119006
MN
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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