Individual
MELISSA GHORMLEY MATTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCP
Contact information
Practice address
1JARRET WHITE ROAD, TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS, TRIPLER AMC, HI 96859-5001
(808) 433-2460
(808) 433-1558
Mailing address
1JARRET WHITE ROAD, TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS, TRIPLER AMC, HI 96859-5001
(808) 433-2460
(808) 433-1558
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2000160632
MO
Other
Enumeration date
07/01/2006
Last updated
07/08/2007
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