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Individual

MR. MATTHEW J RIEDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS CCCA

Contact information

Practice address
111 S MADISON ST, GREEN BAY, WI 54301-4501
(920) 432-7986
Mailing address
111 S MADISON ST, GREEN BAY, WI 54301-4501
(920) 432-7986

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147-156
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41119400
WI
Enumeration date
04/10/2008
Last updated
04/10/2008
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